The Billing Specialist is responsible for ensuring the accurate and timely submission of claims to payers, maintaining compliance with industry standards, and ensuring billing accuracy. This role focuses on exact claim preparation, attention to detail, and proper documentation to minimize errors and maximize clean claim rates. The ideal candidate will have a solid understanding of medical billing practices and payer requirements.
Core Responsibilities:
Prepare and submit accurate claims in accordance with payer guidelines and customer billing cycles
Ensure all claim details are complete and error-free, including coding, provider information, and service dates
Review claims for accuracy and compliance with Medicaid, Medicare, VA, and payer regulations
Verify correct taxonomy codes, modifiers, and billing procedures to prevent rejections
Maintain a high clean-claims submission rate by thoroughly reviewing and validating claim information before submission
Ensure compliance with industry regulations, payer policies,
and internal billing procedures
Maintain accurate and organized billing records and documentation
Identify and report billing trends, potential errors, and areas for process improvement
Collaborate with internal teams to standardize billing practices and enhance efficiency
Support billing audits and internal quality control measures
Other duties as assigned
Experience and Skills:
Experience working in billing and health care preferred
Customer service experience preferred
Excellent follow-up, time management, and communication skills required
Proficiency in MS Office Suite (Outlook, Word, Excel) is required
Familiar with Careclaim MB software (prefer)
Back-office support & Email customer invoicing
Amenable in working in a graveyard shift and working onsite.
Ready to take your career to the next level? Apply now and be part of our agile team!