Medical Claims and Billing Specialist
$54,080–$60,320 year
Remote · United States
Job Summary
Medical Claims & Billing Specialist responsible for the end-to-end revenue cycle for a healthcare organization, from claims submission to payment posting and denial/outstanding claims resolution. Collaborates with Enrollment Team to resolve insurance eligibility issues and handles patient billing inquiries. Key duties include accurate billing to third-party payers, insurance payment posting, account reconciliation, identifying/correcting billing errors, rectifying denials/edits, and communicating with patients about outstanding balances. Requires CPT/ICD coding knowledge, ANSI 837/835 familiarity, strong written/verbal communication, and a collaborative, analytical approach to improve revenue flow while upholding high ethical standards.
Required Qualifications
- 5+ years of experience in a healthcare setting specific to billing and accounts receivable
- Ability to interpret and apply insurance payer billing guidelines, claim rules, and contract terms
- Proficiency in government, commercial and/or insurance payer claims follow-up, denial resolution, and appeals processes
- CPT and ICD coding knowledge
- Knowledge of ANSI 837 and 835 files, including how to read and interpret
- Exceptional written and verbal communication
- Team-focused; effective collaboration. Serves both the team and the customer at a consistently high level
- Demonstrates problem-solving and analytical skills appropriate for the position
- Demonstrates high ethical standards of behavior
- Maintains composure under pressure
- Regularly demonstrates Boulder’s core values
- Experience with multiple payers
- Experience with payment plans and financial assistance applications
- Remote-friendly work environment
Additional Requirements
- Must reside and work in one of the following states: AZ, FL, GA, ID, IL, KY, MA, NC, NJ, NV, NY, OH, OR, PA, SC, TN, TX, UT, WA, WV
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