Medical Billing Specialist

Role Overview

We are hiring a Medical Billing Specialist with deep experience in healthcare billing and a working knowledge of accounting and operational reporting. This role is responsible for executing and reconciling billing activity end-to-end, with a focus on Medicaid and national insurance payers.

This position also plays a critical role in ensuring data integrity across billing, clinical, and operational systems, working closely with data, clinical, and onboarding teams to maintain accurate and timely inputs that directly impact billing, collections, and payouts.

Key Responsibilities

Medical Billing & Claims Management

• Manage full-cycle medical billing: charge entry, claims submission, payment posting, and denial resolution
• Submit and track claims through clearinghouses and payer-specific payment portals
• Work primarily with Medicaid and national insurance companies
• Investigate and resolve denials, rejections, and underpayments
• Maintain accurate billing records

Accounts Receivable & Reconciliation

• Reconcile AR across billing systems and financial records
• Identify discrepancies between expected reimbursements and actual payments
• Own AR aging review and resolution
• Support month-end close with validated AR balances

Payroll & Payout Support

• Validate payroll inputs tied to billing activity
• Reconcile payroll/payout data against billing records
• Flag inconsistencies impacting compensation

Cross-Functional Data Collaboration

• Partner with data teams on data accuracy and pipelines
• Work with clinical teams on documentation and coding validation
• Collaborate with onboarding teams for correct system setup
• Identify upstream data issues and drive resolution

Data Analysis & Reporting

• Analyze billing and AR data for trends and issues
• Produce recurring reports and support ad hoc analysis

Business Intelligence & Systems

• Utilize reporting dashboards from Business Intelligent tools for data and daily operation
• Improve reporting and billing workflows
• Collaborate with data teams to improve the company data reports and data quality