Medical Billing Specialist

Job Description

Job Description

We are looking for a Medical Billing Specialist to join a healthcare team in Syracuse, New York. This Contract to permanent opportunity is ideal for someone who can manage billing activity with accuracy, communicate effectively with patients and payers, and help improve reimbursement outcomes. The role supports daily revenue cycle operations through diligent follow-up, documentation, and account review while maintaining compliance with billing and privacy standards.

Responsibilities:
• Pursue open insurance balances by contacting payers, researching unpaid or underpaid claims, and driving issues through to resolution.
• Examine denied or rejected claims, determine the reason for nonpayment, and complete the necessary corrections to support successful reimbursement.
• Prepare and submit appeals, reconsideration requests, and required documentation in alignment with carrier-specific guidelines.
• Monitor accounts receivable aging and prioritize follow-up on time-sensitive accounts, including those nearing timely filing limits.
• Review patient statements before release to confirm the accuracy of charges, payments, contractual adjustments, insurance activity, and remaining balances.
• Assess patient and insurance refund requests by validating account history, payment activity, and compliance requirements before processing.
• Respond to patient billing inquiries and explain claim status, insurance determinations, and out-of-pocket responsibility in a clear manner.
• Post patient payments accurately and ensure funds are applied correctly to outstanding account balances.
• Verify insurance eligibility, coverage details, and benefit information as needed to support billing and collection efforts.
• Maintain thorough account notes and records of follow-up activity while adhering to privacy regulations, payer rules, and department procedures.• Prior experience in medical billing, claims follow-up, or accounts receivable within a healthcare setting.
• Working knowledge of medical coding concepts and insurance reimbursement processes.
• Ability to research claim denials, payment variances, and billing discrepancies with strong attention to detail.
• Experience handling medical collections and communicating with insurance carriers and patients regarding account status.
• Familiarity with ePaces and other billing or practice management systems.
• Understanding of patient payment posting, refund review, and insurance eligibility verification.
• Knowledge of billing compliance standards, documentation practices, and applicable privacy regulations.