Medical Billing & Claims Specialist

• Post and process medical claims accurately and efficiently
• Manage claims for medical procedures from submission through resolution
• Review claims for completeness and accuracy before processing
• Maintain accurate posting and billing records
• Manage a consistent daily volume of claims while maintaining quality and accuracy
• Track claim status and follow up on outstanding claims
• Ensure claims are processed according to established billing and compliance requirements
• Review and work denied or rejected claims
• Identify reasons for denials and take corrective action
• Resubmit or follow up on claims as necessary
• Work toward successful claim overturns and reimbursement
• Document denial actions and claim follow-up accurately
• Identify recurring billing or denial issues
• Provide billing support to the existing in-house billing team
• Assist with complex billing scenarios, including multiple patient reimbursements
• Review payer information and billing documentation
• Maintain organized and accurate billing records
• Follow compliance and confidentiality requirements
• Assist with additional billing-related responsibilities as assigned
• Work toward at least 80 claims posted per day and approximately 85–90% successful resolution/payment of worked claims

• Minimum 2–3 years of medical billing experience
• Hands-on claims posting experience is required
• Strong experience managing claims for medical procedures is required
• Experience working denied and rejected claims through resolution
• Strong understanding of the medical billing and claims lifecycle
• Ability to investigate claim issues and determine appropriate next steps
• Experience handling complex billing scenarios
• Strong understanding of billing accuracy, compliance, and confidentiality requirements
• Ability to manage a high volume of claims while maintaining accuracy
• Strong attention to detail and organizational skills
• Able to work independently and consistently meet productivity expectations
• Clear and professional written and spoken English
• Reliable, accountable, and comfortable working as part of an established billing team
• Must speak and write English clearly and professionally
• Must have relevant work experience
• Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory)
• Must be available to attend video meetings with camera on when required
• Reliable laptop or desktop computer
• Stable high-speed internet connection (minimum 25 Mbps)
• Noise-canceling headset
• Working webcam for virtual meetings
• Quiet and professional work environment

• Dedicated HR & Contractor Support Team
• Premium VPN Access (Optional)
• HIPAA & Cybersecurity Training + Certification (Provided)
• Top 1% VA Performance Training
• Client-Approved U.S. Holidays
• Client-Approved Paid or Unpaid Time Off
• Access to Tools & Resources
• Optional Performance-Based Incentives
• Optional bonuses, incentives, or increased hours based on performance