Medical Billing Representative

Role Overview

• Prepare and submit clean, accurate claims to insurance companies via electronic systems, mail, or fax.
• Respond to inquiries from providers, staff, and insurance companies regarding billing concerns.
• Identify, troubleshoot, and resolve billing discrepancies or complaints.
• Review accounts and recommend next steps to the Billing Team Lead for resolution or escalation.
• Perform collection activities including follow-ups, claim corrections, and resubmissions to third-party payers.
• Process insurance payments and maintain accurate daily deposit records.
• Generate and maintain daily, weekly, and monthly billing and collection reports.
• Participate in mandatory monthly staff meetings.
• Maintain strict confidentiality of patient health information and ensure full compliance with HIPAA regulations.

Requirements

• 1–3 years of proven experience in medical billing and collections.
• Proficiency in Electronic Medical Record (EMR) systems.
• Strong understanding of healthcare billing codes (CPT, ICD-10) and claims submission procedures.
• Familiarity with medical coding, third-party payer operations, and healthcare collections.
• Working knowledge of HIPAA and PHI confidentiality standards.
• High attention to detail and ability to create consistent financial workflows.
• Excellent communication skills for engaging with providers, staff, and documentation teams.
• Strong interpersonal skills and ability to thrive in a collaborative team environment.