Process primary and secondary medical claims, review and correct billing discrepancies, follow up on denials and outstanding reimbursements, interpret Explanation of Benefits information, and maintain accurate billing records. The role requires collaboration with insurers and internal teams, strong attention to detail, effective communication, organization, and the ability to manage high-volume work across multiple systems.
As a Billing Representative, you will support medical billing and claims activities in a high-volume healthcare environment. You will help ensure claims are complete and accurate, research and resolve billing discrepancies, follow up on outstanding or denied claims, and work with internal partners to improve billing outcomes. Success in this role requires strong attention to detail, analytical and problem-solving skills, effective communication, and the ability to learn and navigate multiple systems while managing competing priorities.
Responsibilities:
- Submit and process primary and secondary medical claims.
- Review claims for completeness and accuracy and resolve billing edits or discrepancies.
- Research billing issues and make appropriate corrections to claims.
- Follow up with insurance companies regarding denials, reimbursement, and outstanding claims.
- Read and interpret Explanation of Benefits (EOB) information.
- Maintain knowledge of billing policies, procedures, and payer requirements.
- Communicate effectively with internal teams, insurance carriers, and other stakeholders to resolve issues.
- Work accurately in a high-volume environment while balancing multiple priorities.
- Identify opportunities to improve billing processes and collaborate with team members on continuous improvement.
Qualifications:
- High school diploma, GED, equivalent work experience, or a higher education credential such as an associate, bachelor’s, or advanced degree.
- Must be at least 18 years old.
- Previous medical billing experience is strongly preferred; relevant office, administrative, clerical, collections, or customer-service experience may also be applicable depending on the position.
- Comfortable using Windows-based applications and learning new and complex computer systems.
- Strong analytical, research, and problem-solving skills.
- Excellent attention to detail with the ability to maintain data accuracy and integrity.
- Strong written and verbal communication skills with the ability to collaborate effectively with others.
- Ability to multitask, organize work, manage time effectively, and perform in a fast-paced environment.
- Ability to work independently while remaining accountable for quality and timely completion of work.
- For remote positions, ability to maintain a secure, private workspace and reliable high-speed internet access.
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