Medical Billing Specialist

Position Summary

The Medical Billing Specialist serves as the primary point of contact for patients regarding billing, insurance, and account-related inquiries. This role is responsible for explaining charges, resolving billing questions, facilitating payments, and supporting account resolution while ensuring compliance with payer, regulatory, and organizational standards.

Key Responsibilities

• Respond to inbound patient inquiries via phone, email, chat, and written correspondence related to billing statements, balances, and insurance processing.
• Explain charges, payments, adjustments, and insurance benefits in a clear and professional manner.
• Review patient accounts to identify billing issues, payment posting errors, or insurance discrepancies.
• Facilitate patient payments, payment plans, and financial assistance applications in accordance with policy.
• Escalate complex billing, coding, or payer issues to appropriate internal teams.
• Document all patient interactions accurately in the billing or patient accounting system.
• Maintain compliance with HIPAA privacy and security requirements.
• Meet productivity, quality, and customer satisfaction standards.
• Support resolution of patient complaints and disputes in a timely manner.

Education and Experience

• High school diploma or equivalent required
• Associate degree or coursework in healthcare administration or related field preferred
• 1–3 years of experience in medical billing, patient financial services, or healthcare customer service preferred

Skills

• Working knowledge of medical billing terminology, insurance processes, and explanation of benefits (EOBs)
• Understanding of common payer types (Medicare, Medicaid, commercial, self-pay)
• Strong customer service and communication skills, including de-escalation techniques
• Ability to navigate billing systems and multiple software applications
• Attention to detail and accuracy in account review and documentation
• Ability to handle sensitive financial and health information confidentially