Medical Biller / Medical Billing Specialist / Medical Claims Specialist

Role Description We are seeking a detail-oriented and organized medical billing professional to support healthcare billing operations, insurance claim processing, and the accurate management of patient financial records. This role helps ensure that medical services are billed correctly, claims are submitted in accordance with applicable requirements, and payment records are maintained efficiently. The successful candidate will review patient billing information, verify service details, prepare invoices, and process medical claims for submission to insurance providers or other relevant payers. Responsibilities include checking patient demographics, reviewing service codes and supporting documentation, confirming billing details, and ensuring that claims contain the information required for accurate processing. The role also involves maintaining organized records of submitted claims, payments, adjustments, and outstanding balances. A key part of the position involves monitoring claim status, following up on pending submissions, reviewing rejected or denied claims, and coordinating corrections when discrepancies arise. The successful candidate will communicate with healthcare administration teams, insurance representatives, patients, and finance colleagues to clarify billing questions, resolve documentation issues, and support timely reimbursement. Additional responsibilities may include reconciling payments, reviewing explanation-of-benefits statements, processing approved adjustments, tracking outstanding accounts, and preparing billing summaries for internal review. The role may also support pre-authorization documentation, insurance eligibility verification, and the collection of information required to complete claims, depending on organizational procedures. Accuracy, confidentiality, and compliance are essential when handling patient information and financial records. The successful candidate must follow applicable privacy requirements, billing guidelines, payer policies, and internal control procedures. They will help identify recurring billing errors, maintain complete audit trails, and recommend improvements to reduce claim delays and administrative rework. The position requires close coordination with clinical, administrative, and financial teams to ensure that billing information reflects the services provided and that issues are addressed promptly. By maintaining accurate documentation and following claims through each stage of the process, the role contributes to smoother revenue cycle operations, improved reimbursement tracking, and a more organized healthcare billing experience. Qualifications • A degree, diploma, or equivalent qualification in Medical Billing, Healthcare Administration, Accounting, Finance, or a related field is preferred. • Understanding of medical billing procedures, insurance claims processing, patient accounts, and healthcare financial administration. • Familiarity with claim submissions, payment posting, billing adjustments, claim denials, and reimbursement follow-ups. • Ability to review billing records, verify supporting documentation, identify discrepancies, and maintain accurate financial information. • Knowledge of medical terminology, procedure codes, diagnosis codes, or relevant coding systems is an advantage. • Familiarity with healthcare management systems, electronic health records, billing platforms, and insurance portals is beneficial. • Proficiency in Microsoft Office applications, particularly Excel, for record management and billing reports. • Strong numerical ability, attention to detail, and organizational skills. • Clear communication skills for coordinating with patients, healthcare teams, insurance providers, and administrative departments. • Understanding of patient confidentiality, data protection, and applicable healthcare billing requirements. • Ability to manage multiple claims, prioritize deadlines, and follow established procedures consistently. • Integrity, discretion, problem-solving ability, and a proactive approach to improving billing accuracy and operational efficiency. Show more Show less

A degree, diploma, or equivalent qualification in Medical Billing, Healthcare Administration, Accounting, Finance, or a related field is preferred. Understanding of medical billing procedures, insurance claims processing, patient accounts, and healthcare financial administration. Familiarity with claim submissions, payment posting, billing adjustments, claim denials, and reimbursement follow-ups. Ability to review billing records, verify supporting documentation, identify discrepancies, and maintain accurate financial information. Knowledge of medical terminology, procedure codes, diagnosis codes, or relevant coding systems is an advantage. Familiarity with healthcare management systems, electronic health records, billing platforms, and insurance portals is beneficial. Proficiency in Microsoft Office applications, particularly Excel, for record management and billing reports. Strong numerical ability, attention to detail, and organizational skills. Clear communication skills for coordinating with patients, healthcare teams, insurance providers, and administrative departments. Understanding of patient confidentiality, data protection, and applicable healthcare billing requirements. Ability to manage multiple claims, prioritize deadlines, and follow established procedures consistently. Integrity, discretion, problem-solving ability, and a proactive approach to improving billing accuracy and operational efficiency.

Review patient billing information, verify service details, prepare invoices, and process medical claims for submission to insurance providers or other relevant payers. Check patient demographics, review service codes and supporting documentation, confirm billing details, and ensure that claims contain the information required for accurate processing. Maintain organized records of submitted claims, payments, adjustments, and outstanding balances. Monitor claim status, follow up on pending submissions, review rejected or denied claims, and coordinate corrections when discrepancies arise. Communicate with healthcare administration teams, insurance representatives, patients, and finance colleagues to clarify billing questions, resolve documentation issues, and support timely reimbursement. Reconcile payments, review explanation-of-benefits statements, processing approved adjustments, tracking outstanding accounts, and preparing billing summaries for internal review. May support pre-authorization documentation, insurance eligibility verification, and the collection of information required to complete claims. Ensure privacy, billing guidelines, payer policies, and internal controls are followed. Identify recurring billing errors, maintain audit trails, and recommend improvements to reduce claim delays and administrative rework. Coordinate with clinical, administrative, and financial teams to ensure billing information reflects services provided and address issues promptly.