Medical Billing Specialist

Job Summary

Medical Billing Specialist

The Sisters of Mercy of the Americas

Part-time

In-Office | Cumberland , RI, United States

The Opportunity

You’re the kind of person who is always looking to learn. You want to grow into something greater and you’re looking for an employer encourages and supports your professional development. The Sisters of Mercy of the Americas promotes advancement and rewards our employees based on individual performance and merit. Sure you’ll have exposure to the team, but all of our people are accountable for their success. Competitive and focused, our team is on a mission to deliver excellence. We also know that this can only be accomplished by supporting our employee growth and development. By providing frequent feedback and consistently measuring progress, we’ve discovered the recipe for success that’s delivered year over year growth since our first year of business. This a culture of winning. At The Sisters of Mercy of the Americas we breed winners.

Responsibilities

• Process medical claims accurately and submit timely to insurance payers.

• Monitor and follow up on aging receivables to optimize cash flow.

• Maintain compliance with HIPAA and payer-specific guidelines.

• Verify patient eligibility and benefits prior to claim submission.

• Resolve claim denials through root-cause analysis and resubmission.

• Generate regular performance metrics and pipeline reports for stakeholders.

• Perform coding reviews to ensure compliant and precise billing.

• Maintain accurate patient and insurance data in the billing system.

• Collaborate with clinical and administrative teams to resolve billing issues.

• Identify process improvements to increase billing accuracy and efficiency.

• Provide patient-friendly explanations for billing questions and concerns.

• Support on-site training and mentorship for junior billing staff.

Experience/Qualifications

• Experience with medical claim submission and payer follow-ups

• HIPAA compliance and patient data privacy knowledge

• Eligibility verification and benefits investigation

• Denial management with root-cause analysis

• Coding review and accuracy in medical billing

• Maintain and update patient/insurance data in billing system

• Pipeline and performance metric reporting for stakeholders

• Interdepartmental collaboration with clinical and admin teams

• Process improvement identification for billing efficiency

• On-site training and mentorship of junior billing staff

What's in it for you? (Salary, Commissions & Benefits)

• On-site position based in Cumberland, RI — collaborate face-to-face with your team in our local office

• Competitive base salary as the primary compensation component