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Job Type:

Full-time Location:

Edinburg, VA -

In Person Schedule:

Monday-Friday, Day Shift About the Position MedLink Billing Solutions is seeking a dependable, detail-oriented Revenue Cycle Specialist to join our team in Edinburg, Virginia. This position is ideal for someone who already has experience working with healthcare insurance claims and understands that successful revenue cycle management involves much more than simply submitting claims. The Revenue Cycle Specialist will be responsible for researching unpaid and denied claims, communicating with insurance carriers, interpreting EOBs and remittance advice, preparing appeals, posting payments and adjustments, and documenting follow-up activity across multiple client EHR systems. Because we provide revenue cycle services for multiple healthcare practices, the ideal candidate must be comfortable managing multiple accounts, payer requirements, EHR systems, and priorities while maintaining accurate and thorough documentation. Key Responsibilities Review outstanding insurance claims and determine the appropriate follow-up action. Contact commercial insurance carriers and government payers to research unpaid, underpaid, rejected, and denied claims. Use payer portals, electronic systems, email, and telephone communication to obtain claim status and resolve reimbursement issues. Ask appropriate follow-up and probing questions when speaking with payer representatives rather than relying solely on basic claim-status information. Review and interpret EOBs, ERAs, and Remittance Advice (RA) to identify denials, adjustments, patient responsibility, and payment discrepancies. Research denied claims and determine the underlying cause of the denial. Correct and resubmit claims when appropriate. Prepare, submit, and follow up on insurance appeals. Identify potential underpayments and reimbursement discrepancies. Accurately post insurance payments, patient responsibility, contractual adjustments, and other required adjustments to client accounts. Maintain clear, detailed documentation of all claim follow-up activity within multiple client EHR systems. Track outstanding claims through resolution rather than completing only the initial follow-up. Recognize recurring payer issues and communicate denial, payment, or adjudication trends to management. Maintain familiarity with multiple payer portals and client EHR systems. Meet established productivity and quality standards while maintaining accuracy. Protect patient information and follow HIPAA and confidentiality requirements. Provide professional and courteous service when communicating with insurance representatives, healthcare providers, clients, and internal team members. Stay current on payer requirements, healthcare billing practices, and revenue cycle trends. Collaborate effectively with other members of the MedLink team. Perform additional revenue cycle duties as assigned.

Qualifications Required:

Minimum of 1 year of healthcare revenue cycle, medical billing, insurance follow-up, or claims processing experience within a physician practice, behavioral health practice, dental practice, medical billing company, or health insurance organization. Working knowledge of the healthcare revenue cycle and insurance claim process. Experience researching denied and unpaid insurance claims. Ability to read and understand EOBs, ERAs, and payer remittance information. Familiarity with CPT, HCPCS, ICD-10-CM, modifiers, and medical terminology. Experience working with electronic health record (EHR) or practice management systems. Strong attention to detail and ability to maintain accurate documentation. Strong problem-solving and critical-thinking skills. Professional written and verbal communication skills. Ability to organize and prioritize a high volume of claims and follow-up tasks. Ability to work independently while also contributing as part of a team. Comfortable learning and working within multiple software platforms and EHR systems.

Preferred:

Experience with behavioral health or mental health billing. Experience working for a medical billing or revenue cycle management company. Experience preparing insurance appeals and resolving complex claim denials. Experience with commercial insurance, Medicare, Medicaid, and/or managed care plans. Experience identifying underpayments and payer processing errors. What We're Looking For The successful candidate is someone who is naturally curious and persistent when researching claims. We are looking for someone who does not stop at \"the claim denied,\" but instead wants to understand why it denied, what needs to be corrected, and what steps are necessary to get the claim resolved and paid correctly. You should be comfortable researching payer policies, asking detailed questions, documenting your work thoroughly, and following claims through to resolution. Accuracy, accountability, organization, and follow-through are extremely important in this position. Benefits Paid time off Paid holidays Monday-Friday schedule Daytime hours No weekends Opportunities to expand your knowledge of healthcare billing and revenue cycle management Schedule 8-hour shift Day shift Monday through Friday Work Location This is an in-person position located in Edinburg, Virginia 22824. Applicants must be able to reliably commute to Edinburg, VA, or relocate prior to beginning employment. Compensation $35,000-$40,000 per year Compensation will be based on relevant healthcare billing, revenue cycle, denial management, and insurance follow-up experience. Apply If you have healthcare revenue cycle experience, enjoy solving complex insurance claim issues, and take pride in seeing claims through to resolution, we encourage you to apply. Please submit your resume highlighting your experience with medical billing, insurance claim follow-up, denial management, EOB/ERA review, appeals, and EHR systems.

Pay:

$35,000.00 - $40,000.00 per year

Benefits:

Paid time off

Work Location:

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Find & Apply For Billing Clerk / Specialist Jobs in Edinburg, Virginia

Revenue Cycle Specialist Medical & Behavioral Health Billing