Medical Billing Specialist

Branson Pulmonology & Sleep
Branson, Missouri

This full-time position is scheduled Monday through Friday. This is not a remote position

Branson Pulmonology & Sleep is seeking an experienced, detail-oriented Medical Biller to join our team. The ideal candidate will have strong knowledge of medical billing, insurance processes, prior authorizations, EHR systems, and accounts receivable, with excellent attention to detail and a commitment to providing accurate and timely billing support.

Key Responsibilities

• Submit, post, and follow up on medical insurance claims accurately and timely.
• Verify patient insurance eligibility and benefits prior to appointments and procedures.
• Obtain and manage prior authorizations and pre-certifications for services, procedures, medications, testing, and other treatments as required by insurance plans.
• Monitor authorization status and communicate with clinical and administrative staff regarding outstanding authorizations.
• Review and correct claim errors, denials, rejections, and unpaid claims.
• Research and resolve insurance denials and payment discrepancies.
• Prepare and submit appeals and supporting documentation for denied or underpaid claims.
• Perform accounts receivable follow-up, including contacting insurance companies regarding outstanding balances.
• Post insurance and patient payments accurately and reconcile accounts.
• Review EOBs/ERAs and ensure payments are posted correctly.
• Maintain accurate patient account information and insurance records within the EHR/practice management system.
• Work with patients regarding billing questions, balances, statements, and insurance issues when needed.
• Maintain knowledge of payer requirements, billing guidelines, CPT/ICD-10 coding concepts, and timely filing requirements.
• Assist with monthly billing reconciliation and reporting.
• Utilize QuickBooks for applicable financial and bookkeeping responsibilities.
• Maintain organized documentation of claims, authorizations, appeals, correspondence, and payment activity.
• Protect patient confidentiality and comply with HIPAA and applicable healthcare regulations.
• Communicate effectively with providers, clinical staff, patients, insurance companies, and outside billing contacts.
• Perform other billing and administrative duties as needed.

Qualifications

• Previous experience in medical billing and/or medical collections preferred
• Experience with prior authorizations and insurance verification preferred.
• Experience handling insurance denials, appeals, and claim follow-up preferred.
• Experience working with an EHR/practice management system preferred.
• Familiarity with Medicare, Medicaid, commercial insurance, and managed-care plans preferred.
• Strong understanding of medical billing workflows and insurance terminology preferred.
• Excellent attention to detail and organizational skills.
• Strong written and verbal communication skills.
• Ability to work independently, prioritize multiple tasks, and meet deadlines.
• Must maintain strict confidentiality of patient and practice information.

Experience in pulmonology, sleep medicine, or a specialty medical practice is a plus, particularly experience with insurance requirements and authorizations related to pulmonary and sleep services.

Job Type: Full-time

Pay: $16.00 - $20.00 per hour

Benefits:

• Paid time off
• Tuition reimbursement

Experience:

• ICD-10: 1 year (Preferred)

Work Location: In person

Salary : $16 - $20