Medical Billing and Follow-Up Specialist

Medical Billing and Follow-Up Specialists will investigate and resolve unpaid or denied insurance claims by contacting insurance carriers and patients, documenting claim status, filing appeals, and correcting billing errors to ensure timely reimbursement and accurate account resolution. Key responsibilities include claims research, payment posting, handling billing inquiries, and using medical billing software to manage the revenue cycle. This role requires strong customer service, communication, and problem-solving skills to ensure accurate billing and patient satisfaction. 

Key Responsibilities

• Claims Management: Reviewing claims for accuracy and completeness, identifying coding errors, correcting and completing forms, and filing corrected claims and appeals. 


• Insurance Communication: Contacting insurance carriers and third-party payers to resolve pending claims, clarify billing issues, and investigate denials. 


• Patient Communication: Communicating with patients to collect outstanding balances, answer billing inquiries, and address concerns related to their accounts. 


• Documentation and Reporting: Maintaining accurate and updated records of outstanding accounts, tracking claim statuses, documenting reasons for denials, and reporting on billing performance. 


• Problem Resolution: Identifying and resolving issues such as coordination of benefits, and account credit balances. 


• Payment Posting: Posting ERA, EOB’s and Other Remittances, and Collecting Patients payments when necessary. Perform additional administrative duties as assigned.
  

Skills and Knowledge

• Medical Billing Software: Proficiency with relevant medical billing and patient accounting systems. 


• Medical Terminology and Coding: Basic knowledge of ICD-10/HCPCS/CPT codes and medical terminology. 


• Insurance Knowledge: Familiarity with third-party insurance plans and benefit coverages. 


• Computer Skills: Intermediate knowledge of Microsoft Word and Excel, along with the ability to learn new programs. 


• Communication Skills: Excellent verbal and written communication skills for interacting with insurance carriers, patients, and internal team members. 


• Analytical Skills: Ability to research and resolve complex issues related to billing, payments, and denials. 

Additional Requirements:

• Participation in team meetings


• Willingness to learn and share knowledge and ideas for improvement in the team


• Able to follow both written and verbal instructions accurately.


• Strong interpersonal skills to communicate tactfully and professionally with staff, patients, providers, and the public.


• Flexible, reliable, and able to work independently and collaboratively as a member of a team.


• Capable of setting priorities, managing time effectively, and handling multiple projects with competing deadlines.


• Willing and able to take on all departmental duties as required.