A growing healthcare organization in North County is looking for a detail-driven Medical Billing Specialist to support claims processing, insurance follow-up, payment posting, and account resolution. This is an excellent opportunity for someone who enjoys investigative work, understands the importance of accurate documentation, and wants to play a meaningful role in the revenue cycle. The organization needs someone who can look beyond a rejected claim, determine what went wrong, and take the appropriate steps to get it corrected. You'll collaborate with internal billing staff, insurance representatives, and other departments to reduce outstanding balances and keep accounts moving toward resolution. Candidates with medical billing, insurance claims, or revenue cycle experience will be especially well suited for this role.
Key responsibilities:
- Prepare and submit medical claims to insurance companies and other payers.
- Review claim information for completeness, accuracy, and proper supporting documentation.
- Investigate rejected or denied claims and correct errors before resubmission.
- Follow up with insurance carriers regarding unpaid claims and outstanding balances.
- Post insurance payments, patient payments, adjustments, and contractual write-offs.
- Research underpayments and discrepancies between expected and actual reimbursement.
- Verify insurance information and assist with eligibility questions as needed.
- Maintain accurate account notes and billing records.
- Respond to billing inquiries from patients, payers, and internal departments.
- Track aging claims and prioritize accounts requiring additional follow-up.
- Assist with monthly AR reports and revenue cycle tracking.
- Protect confidential patient information and follow applicable privacy requirements.
- 1–3+ years of medical billing, insurance claims, or healthcare accounts receivable experience.
- Understanding of claim submission, denial management, and payment posting.
- Familiarity with payer portals and medical billing software.
- Strong data entry and Excel skills.
- Excellent organization and attention to detail.
- Professional communication skills and persistence with follow-up.
- Knowledge of CPT, ICD-10, and insurance terminology is preferred.
- Experience with electronic health records or practice management systems is a plus.