Back-End Medical Billing Specialist

Position Overview

Essential Duties & Responsibilities

• A/R & Claims Resolution: Manage accounts receivable aging reports to resolve unpaid claims outstanding past 30 days. Execute line-item payment posting and pursue timely collections according to established department performance standards.
• Denials & Appeals: Investigate claim rejections, gather supporting documentation, and resubmit corrected claims promptly. Document unbillable denial reasons and escalate trends to the Billing Supervisor.
• Patient & Payer Communication: Field incoming inquiries from patients and insurance representatives professionally. Verify coverage details with external eligibility systems and appropriate internal departments.
• System & Administrative Accuracy: Maintain clean audit trails in the practice management system. Report billing system bugs or workflow obstacles to management, and execute special billing initiatives as needed.
• Professional Standards: Comply with HIPAA and organizational privacy policies, maintain punctuality and professional attire, and resolve workplace conflicts constructively.

Core Qualifications

• Education: High School Diploma or equivalent required (some college or vocational coursework preferred).
• Experience: Minimum 2 years in medical accounts receivable management.
• Technical Skills: Experience with outpatient billing workflows, primary coding standards (CPT, ICD-9), and claim form completion (HCFA-1500 / UB-04). Proven track record navigating insurance appeal processes.
• Software Proficiency: Familiarity with practice management platforms, spreadsheet software, and standard word processing applications.
• Operational Skills: Accurate 10-key operation, 30+ WPM typing speed, and strong professional decision-making capabilities.

Working with PMC Medical Staffing