Required Qualifications and Skills

- Manage medical billing activity across the revenue cycle, including insurance claims, EOBs, COB, denial management, and appeals.
- Review claims, payments, denials, and discrepancies to support accurate reimbursement.
- Perform insurance verification and follow up with payers to resolve outstanding billing issues.
- Maintain accurate billing records while supporting healthcare compliance and patient privacy requirements.

- Minimum of 2 years of healthcare industry experience in medical billing, insurance claims processing, revenue cycle management, or a related healthcare financial role.
- Recent, hands-on healthcare billing experience is required.
- Healthcare experience is required. Candidates without medical billing or healthcare revenue cycle experience will not be considered.
- Experience filing, tracking, and resolving medical insurance claims.
- Experience reviewing and interpreting Explanation of Benefits documents.
- Experience handling Coordination of Benefits and insurance verification.
- Experience managing claim denials, appeals, billing escalations, and payment discrepancies.
- Strong knowledge of HIPAA regulations, patient privacy standards, and healthcare compliance requirements.
- Working knowledge of ICD-10 coding, medical terminology, and insurance billing procedures.
- Familiarity with commercial insurance, Medicare, and Medicaid claims processing.
- Proficiency with EMR/EHR systems, billing platforms, and Microsoft Office applications.
- Strong communication, customer service, problem-solving, accuracy, and attention to detail.
- Ability to work effectively in a fast-paced healthcare environment.

Preferred Qualifications

- Prior experience in a medical office, hospital, or medical devices, medical supplies, durable medical equipment, or related healthcare billing environment.
- Experience working with high-volume claims follow-up and payer resolution.
- Familiarity with denial trends, reimbursement workflows, and revenue cycle process improvement.