Medical Billing Specialist (US Healthcare)

Job Summary: (Blended)

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong focus on claims rejections, denials, and processing. The ideal candidate will be responsible for identifying, analyzing, and resolving rejected or denied insurance claims to ensure maximum reimbursement and accurate claim submission.

Key Responsibilities:

* Review and analyze rejected or denied insurance claims from both government and commercial payers.

* Identify reasons for claim denials or rejections (e.g., coding errors, eligibility issues, missing information).

* Correct and resubmit claims in a timely manner to avoid delays in reimbursement.

* Work closely with payers to resolve complex denial issues and appeal claims when necessary.

* Communicate with providers, patients, and internal teams to gather necessary documentation or clarification.

* Maintain up-to-date knowledge of payer-specific requirements, billing guidelines, and coding updates (ICD-10, CPT, HCPCS).

* Track and document all actions taken on rejected or denied claims in the billing system or practice management software.

* Generate and analyze rejection and denial reports to identify trends and recommend process improvements.

* Ensure compliance with HIPAA regulations and company policies during claims handling.

Night Shift - 9:00 PM - 6:00 AM | Mon - Fri (Sat - Sun off)