Medical Billing Specialist job description template
A medical billing specialist turns each visit into a clean claim and makes sure the practice actually gets paid by entering charges, submitting claims, posting payments and working denials until they're resolved. In a small practice one person often handles the whole billing cycle, so the best posts name your specialty, your main insurance payers, your billing software and whether the role is on-site, hybrid or remote.
Medical Billing Specialist
Full-timeYour Company is looking for a medical billing specialist to keep our claims clean and our accounts receivable under control. You'll review charges and codes, submit claims, post insurance and patient payments, and follow denials until they're paid or resolved. You'll also help patients understand their bills with patience and clear answers. If you like solving puzzles, know your way around CPT and ICD-10 codes, and follow through until the job is done, we'd like to meet you.
What you’ll do
- Review visit charges, CPT and ICD-10 codes and modifiers for accuracy before claims go out
- Submit claims electronically through our clearinghouse and correct rejections the same day
- Post insurance payments, adjustments and patient payments from ERAs and EOBs, and match them to deposits
- Work denied and underpaid claims by correcting and resubmitting them or filing appeals with records
- Follow up on unpaid claims from the aging report by calling payers and checking portals before deadlines
- Send patient statements, answer billing questions by phone and set up payment plans following our policy
- Flag coding and documentation problems to providers so the same denial doesn't keep coming back
- Keep payer rules, fee schedules and insurance enrollment details current in our practice management system
What we’re looking for
- Experience in medical billing, claims follow-up or accounts receivable for a practice or billing company
- Working knowledge of CPT, ICD-10-CM and HCPCS codes and common modifiers
- Familiarity with Medicare, Medicaid and commercial insurance claim rules
- Comfortable working in practice management software, spreadsheets and payer portals
- Persistent, organized and careful with numbers, dates and account details
- Committed to protecting patient health and financial information under HIPAA
Nice to have
- Billing or coding certification such as CBCS (NHA), CPB or CPC (AAPC), or CCS (AHIMA)
- Experience billing for our specialty, such as behavioral health, physical therapy or dermatology
- Experience with provider credentialing and payer enrollment
- Experience with billing systems such as AdvancedMD, NextGen or athenahealth
Schedule
Full-time, Monday through Friday during business hours. Some remote days may be possible once you're fully trained.
What we offer
- Remote or hybrid work once you know our systems
- Paid AAPC or NHA exam fees and continuing education units
- Medical coverage and an employer-matched retirement plan
- Time off that starts accruing on day one, plus paid holidays
- Dual monitors and a headset for payer calls
Add your pay, location and schedule when you post. Jobs that show pay get noticeably more applicants.
Medical Billing Specialist our company is looking for a medical billing specialist to keep our claims clean and our accounts receivable under control. You'll review charges and codes, submit claims, post insurance and patient payments, and follow denials until they're paid or resolved. You'll also help patients understand their bills with patience and clear answers. If you like solving puzzles, know your way around CPT and ICD-10 codes, and follow through until the job is done, we'd like to meet you. What you’ll do • Review visit charges, CPT and ICD-10 codes and modifiers for accuracy before claims go out • Submit claims electronically through our clearinghouse and correct rejections the same day • Post insurance payments, adjustments and patient payments from ERAs and EOBs, and match them to deposits • Work denied and underpaid claims by correcting and resubmitting them or filing appeals with records • Follow up on unpaid claims from the aging report by calling payers and checking portals before deadlines • Send patient statements, answer billing questions by phone and set up payment plans following our policy • Flag coding and documentation problems to providers so the same denial doesn't keep coming back • Keep payer rules, fee schedules and insurance enrollment details current in our practice management system What we’re looking for • Experience in medical billing, claims follow-up or accounts receivable for a practice or billing company • Working knowledge of CPT, ICD-10-CM and HCPCS codes and common modifiers • Familiarity with Medicare, Medicaid and commercial insurance claim rules • Comfortable working in practice management software, spreadsheets and payer portals • Persistent, organized and careful with numbers, dates and account details • Committed to protecting patient health and financial information under HIPAA Nice to have • Billing or coding certification such as CBCS (NHA), CPB or CPC (AAPC), or CCS (AHIMA) • Experience billing for our specialty, such as behavioral health, physical therapy or dermatology • Experience with provider credentialing and payer enrollment • Experience with billing systems such as AdvancedMD, NextGen or athenahealth Schedule Full-time, Monday through Friday during business hours. Some remote days may be possible once you're fully trained. What we offer • Remote or hybrid work once you know our systems • Paid AAPC or NHA exam fees and continuing education units • Medical coverage and an employer-matched retirement plan • Time off that starts accruing on day one, plus paid holidays • Dual monitors and a headset for payer calls
Screening questions for a medical billing specialist
Ask these on the application form to sort applicants quickly. They’re added automatically when you post this template.
- Do you have hands-on experience submitting medical claims and working insurance denials?Yes / No · required
- Which billing systems, clearinghouses and payer portals have you worked in?Short answer
- Describe a denied claim you got paid and the steps you took to get there.Paragraph
Medical Billing Specialist interview questions
- A claim comes back denied for medical necessity. Walk me through what you do next.
- How do you decide which unpaid claims to work first when the aging report is long?
- Which modifiers do you use most often, and when would you add modifier 25?
- A patient calls upset about a bill they expected insurance to cover. How do you handle the call?
- What's the difference between a claim rejection and a denial, and how do you handle each one?
- How do you spot a pattern in denials, and what do you do once you find one?
- Tell me about a time you found a coding or documentation error. How did you raise it with the provider?
- How do you keep up with payer policy and coding updates each year?
Tips for hiring a medical billing specialist
- Give finalists a short exercise, such as posting a sample EOB and explaining a denial. It quickly shows who understands the work.
- Certification is optional for many billing jobs, but CBCS, CPB or CPC shows formal training. AAPC and NHA both offer online credential lookups.
- Ask which payers candidates have billed most. Someone strong with Medicare may need time to learn Medicaid managed care or workers' compensation claims.
- Because billers handle money, have someone else approve write-offs and review adjustments regularly, even in a small office.