Medical Billing Specialist

Description We are looking for a detail-oriented Medical Billing Specialist to support revenue cycle operations for a healthcare organization in Richmond, Virginia. This contract opportunity with permanent potential is ideal for someone who brings strong knowledge of medical claims, insurance billing, and account follow-up in a fast-paced office setting. The person in this role will help drive timely reimbursement, resolve claim issues efficiently, and deliver a high standard of service to patients and insurance partners.

Responsibilities:

• Monitor aging reports and proactively pursue patient account balances that remain unpaid beyond 60 days from the date of service.
• Submit electronic primary and secondary insurance claims accurately and consistently to support prompt payment processing.
• Investigate rejected, returned, or denied claims and take corrective action quickly, including resubmission and account adjustment when needed.
• Prepare and submit claim appeals with clear supporting documentation to improve reimbursement outcomes.
• Review billing details for accuracy, completeness, coding alignment, and insurance selection before claims are finalized.
• Work directly with insurance carriers and third-party contacts to resolve denials, partial payments, suspended claims, and other reimbursement barriers.
• Research payer-related issues such as coverage questions, network concerns, and workers' compensation claim challenges.
• Reconcile accounts and address correspondence within established turnaround expectations to maintain efficient collections activity.
• Share weekly productivity updates and maintain organized documentation of billing follow-up efforts.
• Provide billing and eligibility guidance related to coding, payer requirements, and insurance coverage questions. Requirements
• At least 2 years of experience in medical billing, insurance reimbursement, account collections, or a closely related healthcare revenue cycle role.
• Previous experience working in a medical office or medical billing environment; 4 to 5 years of experience is preferred.
• Working knowledge of medical terminology, billing practices, coding concepts, and insurance claim processing.
• Proficiency with Microsoft Excel and Microsoft Word.
• Strong customer service and communication skills with the ability to interact professionally with patients and payer representatives.
• High school diploma or equivalent is required.
• Relevant billing or coding certification is preferred.
• Experience with eClinicalWorks is an advantage.

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