The Billing Specialist II is a senior-level role responsible for accurately processing and posting payments and rejections, resolving billing issues, and keeping accounts receivable current. This position supports claim submission, rejected claim follow-up, patient account maintenance, and coordination with insurance carriers and other billing staff.
Key responsibilities include:
- Submit claims promptly and work rejected files at the time of submission
- Maintain AR and monitor credit balances
- Post credit card, EOB, and ERA payment files accurately
- Resolve rejected claims through research, payer follow-up, and resubmission
- Answer patient and insurance calls to resolve claim-related issues
- Support patient payment plans, account cleanup, and collection-related follow-up
- Assist other team members and provide coverage as needed
This is a multi-level billing role with progression based on experience, certifications, and demonstrated independent performance.
Requirements & Qualifications
Required qualifications include:
- High school diploma
- For senior level consideration: associate degree in medical or dental billing, or equivalent coursework and experience
- Minimum 2 years of required experience and 3 years preferred in medical/dental billing for Level II
- Experience processing Explanation of Benefits (EOB) and ERA files
- Knowledge of CPT, ICD-10, LCDs, NCDs, and modifier usage/guidelines
- Experience with rejected and corrected claims, payer guidelines, appeals, and timely filing limits
- Medicaid and Medicare billing experience
- Strong data entry, math, reconciliation, and 10-key skills
- Proficiency with Outlook, Word, and Excel
- Ability to work independently, train others, communicate effectively, and maintain HIPAA compliance
Preferred qualifications:
- CPC, RHIT, or RCC certification
- Experience in family or dental practice
- Bilingual English/Spanish preferred
Location
Michigan, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
2 months ago
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