Medical Billing Specialist

Job Description

Job Description

Medical Billing Specialist

Full-time • 80 hours per pay period • Monday–Friday • Benefited – 8th Street Campus

Black River Health is seeking a detail-oriented, motivated professional to join our Finance & Revenue Cycle team as a Medical Billing Specialist. In this role, you will ensure accurate billing, timely claim submission, effective follow-up, and strong collaboration across departments to support the financial health of our organization.

What You’ll Do

As a Medical Billing Specialist, you will play a key role in ensuring claims are processed accurately and efficiently while supporting both patients and internal teams. Your responsibilities include:

Essential Duties

• Correct, complete, and process claims for all payors according to established standards
• Perform follow‑up with payors on unpaid accounts identified through aging reports, denials, or payer rejections
• Demonstrate thorough knowledge of billing policies and procedures, including editing, denial management, and appeal processing
• Process appeals online or via paper submission, acting as a liaison between healthcare providers and insurance companies to complete appeals, reconsiderations, and corrected claims in a timely manner according to payer contracts
• Collaborate with internal departments to ensure proper billing of claims, reduce denials, and support billing audits as needed
• Answer and respond to correspondence, calls, and concerns related to patient accounts
• Remain current with all regulatory requirements related to billing and adhere to HIPAA regulations and patient confidentiality
• Accurately review payor contracts to ensure appropriate reimbursement
• Review and initiate refund requests as appropriate

Top Candidates Will Bring

• A solid understanding of medical and billing terminology
• Experience managing denied claims and performing denial management
• Familiarity with UB‑04 and CMS‑1500 claim forms
• Experience interacting with representatives from various health plans
• Ability to interpret Explanation of Benefits (EOBs) to assess proper reimbursement
• Knowledge of billing codes

Educational Qualifications

• High School Diploma or General Education Degree (GED)
• 2 years of billing experience preferred; 1 year of medical billing experience ideal
• Proficiently uses a computer, keyboard, and calculator
• Excellent oral and written communication skills

Your Future Starts Here

Black River Health is proud to be one of the Top 100 Best Places to Work in Healthcare, and we live our mission every day: outstanding, compassionate care for you and your family, delivered locally with compassion.

If you’re ready to bring your strengths to a team that truly values you, we’d love to welcome you. Apply today at www.blackriverhealth.com and take the next step in your journey with us.

"Black River Health, Inc. is an equal employment opportunity employer functioning under an Affirmative Action Plan."