Medical Billing Specialist

About Company:

Wellspire Medical Group is a multi-specialty practice serving the Humble, Atascocita, Kingwood, Spring, Cypress, and Memorial City areas. Wellspire Medical Group provides top-tier care with compassion, kindness and respect, prioritizing patients always. – Excellence in Patient Care – Dedication to Quality – Preserving the Worth and Dignity of Every Individual

About the Role:

The Medical Billing Specialist is responsible for accurate and timely charge entry, claim 

submission, and support of the revenue cycle process. This role also provides administrative 

support to the Appeals Team, including faxing, mailing, and maintaining accurate patient 

demographics within the practice management system. The ideal candidate is detail-oriented, 

organized, and able to manage multiple tasks in a fast-paced, multi-specialty environment.

Billing & Claims Management

•  Enter charges accurately into the practice management system based on provider documentation

•  Review claims for completeness and accuracy prior to submission

•  Submit electronic and paper claims to insurance carriers in a timely manner

•  Ensure claims meet payer-specific guidelines and requirements

•  Work claim edits and rejections to ensure clean claim submission

•  Monitor claim status and assist with follow-up as needed

Patient Account & Demographics Management

•  Enter and update patient demographic information accurately

•  Verify completeness of patient accounts prior to claim submission

•  Correct demographic errors that may cause claim denials or delays

•  Maintain confidentiality and compliance with HIPAA regulations

Appeals Team Support

•  Assist with preparing and submitting appeals via fax and mail

•  Print, organize, and compile documentation for appeal packets

•  Track appeal submissions and ensure proper documentation is attached

•  Support Appeals Team with administrative tasks as needed

Administrative Duties

•  Fax and mail documents related to billing, claims, and appeals

•  Scan and upload documents into patient accounts

•  Maintain organized records of submitted claims and appeals

•  Assist with special projects and workflow improvements

Qualifications

•  High school diploma or equivalent required; CPC or billing certification p

•  Minimum 1-2 years of medical billing experience (multi-specialty preferred)

•  Bilingual Spanish Preferred 

•  Knowledge of CPT, ICD-10, and basic billing guidelines

•  Experience with EMR/PM systems (eClinicalWorks preferred)

•  Familiarity with insurance claims, denials, and appeals processes

Skills & Competencies

•  Strong attention to detail and accuracy

•  Excellent organizational and time management skills

•  Ability to prioritize tasks and meet deadlines

•  Strong communication skills (written and verbal)

•  Ability to work independently and as part of a team

Work Environment

•  Fast-paced medical office setting

•  Collaboration with billing, coding, and appeals teams

•  May require handling high claim volumes and time-sensitive tasks

Performance Expectations

•  Timely and accurate charge entry and claim submission

•  Minimal claim errors and rejections

•  Efficient support to Appeals Team workflows

•  Maintenance of accurate patient demographic data