Medical Billing Specialist

Description

Medical Billing Specialist

Integrated Sleep Care, a Pivotal Health Company

📍 Remote

🕒 Full-Time | Remote | Monday–Friday, 8:00 AM – 5:00 PM EDT

Join Our Team

Integrated Sleep Care, a Pivotal Health Company, is committed to improving lives through exceptional sleep medicine services and patient-centered care. We are seeking a motivated and experienced Remote Medical Billing Specialist to join our Revenue Cycle team.

This role is ideal for a healthcare billing professional with experience in physician practice billing, payment posting, insurance follow-up, and account reconciliation. The successful candidate will have a strong understanding of revenue cycle management, medical claims processing, EOBs, ICD-10 coding, and collections while maintaining a high level of customer service and accuracy.

Position Summary

The Billing Specialist is responsible for managing all aspects of medical billing and accounts receivable functions, including claim submission, payment posting, denial management, collections, account reconciliation, and payer follow-up. This position is critical to ensuring timely reimbursement and maintaining the financial integrity of the practice.

Key Responsibilities

Revenue Cycle & Medical Billing

• Submit and track insurance claims for physician and sleep medicine services.
• Review claims for accuracy and completeness prior to submission.
• Utilize knowledge of ICD-10, CPT, and HCPCS coding to identify and resolve billing issues.
• Investigate and resolve claim denials, rejections, and underpayments.
• Submit corrected claims, appeals, and reconsiderations as necessary.
• Ensure claims are filed within payer-specific filing deadlines.

Payment Posting & Reconciliation

• Accurately post payments from insurance carriers and patients using EOBs and ERAs.
• Process payments received via ACH, credit card, checks, and electronic remittance files.
• Reconcile payment postings with daily deposits and billing records.
• Research and resolve payment variances, unapplied payments, and posting discrepancies.
• Process contractual adjustments, refunds, and write-offs according to company guidelines.
• Assist with monthly account reconciliations and reporting.

Accounts Receivable & Collections

• Monitor aging reports and prioritize accounts requiring follow-up.
• Contact insurance companies regarding outstanding claims and reimbursement issues.
• Conduct professional patient collections and assist with payment arrangements.
• Maintain detailed documentation of billing activity and collection efforts.
• Resolve patient billing questions and account concerns promptly and professionally.

Compliance & Collaboration

• Maintain compliance with HIPAA and all regulatory billing requirements.
• Support internal and external audits as requested.
• Collaborate with providers, clinical staff, front office personnel, and leadership to resolve billing issues.
• Maintain confidentiality while handling sensitive patient and financial information.

Qualifications

Education & Experience

• High School Diploma or GED required.
• Associate degree in Healthcare Administration, Medical Billing & Coding, Business, Accounting, or related field preferred.
• Minimum of two (2) years of medical billing, healthcare collections, accounts receivable, or revenue cycle experience required.
• Experience in a physician practice, specialty practice, or sleep medicine environment preferred.

Required Knowledge

• Understanding of:
• Medical billing and revenue cycle processes
• ICD-10 diagnosis coding
• CPT and HCPCS procedure coding
• EOBs (Explanation of Benefits) and ERAs (Electronic Remittance Advice)
• Insurance verification and authorization processes
• Medicare, Medicaid, and commercial payer guidelines
• Accounts receivable management and collections

Technical Skills

• Experience with EHR and Practice Management software.
• Proficient in Microsoft Office Suite, particularly Excel.
• Ability to analyze billing reports and reconcile financial data accurately.
• Strong data entry and account auditing skills.

Professional Skills

• Excellent attention to detail and accuracy.
• Strong communication and customer service skills.
• Effective organizational and time-management abilities.
• Ability to manage multiple priorities in a fast-paced environment.
• Strong analytical and problem-solving skills.
• Ability to work independently and collaboratively within a team.

Preferred Qualifications

• Certified Professional Biller (CPB), CPC, CCA, or similar certification preferred.
• Denial management and appeals experience.
• Sleep medicine, pulmonary, respiratory, or specialty practice billing experience.
• Familiarity with payer portals and electronic claim management systems.

Why Join Integrated Sleep Care?

At Integrated Sleep Care, a Pivotal Health Company, we believe exceptional patient care starts with exceptional team members. Join a growing organization where your expertise directly contributes to improving patient outcomes while working alongside dedicated healthcare professionals in a collaborative and supportive environment.

Schedule: Monday–Friday, 8:00 AM – 5:00 PM

Location: Saginaw, MI (Onsite)

Equal Employment Opportunity

Integrated Sleep Care, a Pivotal Health Company, is an Equal Opportunity Employer. We are committed to fostering an inclusive workplace and providing equal employment opportunities to all qualified applicants regardless of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected status under applicable law.

E-Verify Employer – All applicants must be legally authorized to work in the United States.

Requirements

• Understanding of:
• Medical billing and revenue cycle processes
• ICD-10 diagnosis coding
• CPT and HCPCS procedure coding
• EOBs (Explanation of Benefits) and ERAs (Electronic Remittance Advice)
• Insurance verification and authorization processes
• Medicare, Medicaid, and commercial payer guidelines
• Accounts receivable management and collections