Medical Hospital Billing Specialist

Job Title: Medical Hospital Billing SpecialistLocation: On-site / Hybrid / RemoteDepartment: Revenue Cycle / Patient Financial ServicesEmployment Type: Full-TimePosition SummaryThe Medical Hospital Billing Specialist is responsible for accurate and timely billing of hospital services to insurance payers and patients. This role plays a critical part in the revenue cycle by ensuring claims are submitted correctly, payments are posted appropriately, and accounts are resolved efficiently while maintaining compliance with payer and regulatory requirements.Key ResponsibilitiesPrepare, review, and submit hospital claims (inpatient, outpatient, and/or ancillary services) to commercial, Medicare, and Medicaid payersVerify patient insurance coverage, authorizations, and benefits as neededEnsure accurate charge capture, coding validation, and modifier usage prior to claim submissionMonitor claim status and follow up on unpaid, denied, or underpaid claimsResearch and resolve claim denials, payment variances, and payer rejectionsPost payments, adjustments, and contractual allowances accuratelyMaintain detailed account notes and documentation in the billing systemCommunicate effectively with payers, patients, and internal departments to resolve billing issuesStay current on payer guidelines, billing regulations, and compliance requirementsMeet productivity and accuracy standards established by the departmentQualificationsHigh school diploma or equivalent required; associate's degree preferredMinimum of [1-3] years of hospital billing experience requiredStrong knowledge of hospital billing processes, UB-04 claims, and payer guidelinesFamiliarity with CPT, HCPCS, ICD-10 coding conceptsExperience with Medicare, Medicaid, and commercial insurance payersProficiency with electronic health records (EHR) and billing systemsStrong attention to detail and analytical skillsAbility to manage multiple priorities and work independentlyExcellent written and verbal communication skills Preferred QualificationsExperience in inpatient and outpatient hospital billingKnowledge of denial management and appealsFamiliarity with revenue cycle metrics and AR follow-up workflowsCertification such as CPB, CPC, or equivalent (preferred but not required) Work Environment & BenefitsCollaborative, fast-paced healthcare environmentCompetitive compensation based on experienceComprehensive benefits package including medical, dental, vision, PTO, and retirement optionsOpportunities for professional growth and continuing education**Applicants must be legally authorized to work in the United States. We are unable to sponsor or take over sponsorship of an employment visa at this time.