What are the responsibilities and job description for the Medical Billing Specialist position at Confidential?
Job Summary
A healthcare organization is seeking a highly skilled Medical Billing Specialist to support and oversee core billing operations and the full billing and revenue cycle process. This role ensures accurate claim submissions, utilization reviews, payer follow-ups, denial resolutions, and a strong financial performance. This is a strategic, working manager role for an experienced biller who is ready to step into a leadership track.
Key Responsibilities
- Oversee daily billing operations and ensure timely, accurate claims submission.
- Monitor accounts receivable, aging trends, and outstanding claims.
- Investigate and resolve denials, rejections, and underpayments.
- Process appeals, resubmissions, and payer follow-up communications.
- Submit and manage utilization review for prior authorization, concurrent and retrospective cases.
- Maintaining up to date CAQH for providers
- Updating insurances for provider paneling
- Review documentation and claims for accuracy and compliance.
- Support staff and clinical teams with billing-related questions or corrections.
- Post payments, adjustments, and reconcile accounts when needed.
- Maintain efficient billing workflows and recommend improvements.
- Generate routine financial and AR performance reports.
- Provide leadership support, communication, and guidance to billing staff.
- Identify systemic billing issues and collaborate with leadership to implement solutions.
Required Qualifications
- 3 years of medical billing or revenue cycle experience.
- Strong understanding of commercial, Medicaid, and Medicare billing processes.
- Hands-on experience with prior authorizations, denials, appeals, and payer troubleshooting.
- Familiarity with the full revenue cycle from authorization to payment posting.
- Proficiency with billing systems, clearinghouses, and EHR/EMR platforms.
- Excellent organization, communication, and problem-solving skills.
Preferred Qualifications
- Behavioral health or multisite outpatient experience (not required).
- Knowledge of common service codes (CPT/HCPCS).
- Experience mentoring or guiding other billing personnel.
- Exposure to auditing, compliance, or workflow optimization.
Compensation
- Salary Range: $58,000 – $68,000 annually, depending on experience.
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Retirement contributions
- Flexible and supportive work environment
- Professional development and career growth opportunities.
Pay: $58,000.00 - $68,000.00 per year
Benefits:
- Dental insurance
- Health insurance
- Paid time off
Work Location: Hybrid remote in Waukesha, WI 53186
Salary : $58,000 - $68,000