We are looking for a Medical Billing Specialist to support billing operations for a Contract position based in Providence, Rhode Island. This role focuses on accurate claim processing, insurance follow-up, and account review within a healthcare setting. The ideal candidate brings hands-on medical billing experience, strong attention to detail, and the ability to work effectively with clinical teams and payer contacts.

Responsibilities:

• Maintain accurate patient insurance details and demographic information to support clean claim submission and reduce billing delays.
• Enter charges for assigned programs in a timely manner while ensuring coding and billing data are complete and correct.
• Communicate with insurance carriers to address claim issues, clarify coverage questions, and help resolve reimbursement concerns.
• Advise program leaders and clinical staff on billing expectations, documentation needs, and payer-related procedures.
• Track high-dollar balances and unusual account activity, then escalate trends and concerns to the Billing Manager.
• Review receivables aging on a routine basis to help ensure claims are submitted and worked within payer filing deadlines.
• Research payer policies and billing rules independently to maintain compliance and improve claim accuracy.
• Use Inovalon and related billing tools to manage account activity, document follow-up, and support day-to-day revenue cycle tasks.