Medical Billing Specialist

Position Overview

Prevounce Health is seeking a detail-oriented and organized Medical Billing Specialist to support our growing healthcare operations. This position is responsible for accurately processing medical charges, reviewing billing information, submitting claims, and assisting with billing-related issues to ensure timely and accurate reimbursement.

The ideal candidate will have experience in medical billing, familiarity with Medicare billing guidelines, and the ability to manage a high volume of claims while maintaining accuracy. Experience with Next. Gen and billing for Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) programs is highly preferred.

Key Responsibilities

Accurately enter and process medical charges, ensuring all required patient, provider, and service information is complete. Claims Processing: Review, prepare, and submit medical claims in accordance with payer requirements and established billing procedures. Coding Accuracy: Verify CPT, ICD-10, and HCPCS codes to ensure appropriate billing and documentation.

Medicare Billing: Apply Medicare billing guidelines, including requirements for RPM and CCM services. Claim Corrections: Identify and resolve billing discrepancies, claim edits, and submission errors to minimize delays and denials. Insurance Verification: Review patient insurance information and eligibility to support accurate claims processing.

Billing System Management: Utilize Next. Gen and other billing platforms to enter charges, review claims, and maintain accurate billing records. Productivity & Accuracy: Meet established daily billing and charge entry expectations while maintaining high accuracy standards. Team Collaboration: Communicate with internal departments to resolve missing documentation, coding discrepancies, and other billing-related concerns.

Compliance: Maintain compliance with HIPAA, Medicare regulations, payer guidelines, and company policies. Required Qualifications Minimum of 1 year of experience in medical billing, charge entry, claims processing, or a related healthcare revenue cycle role. Working knowledge of medical billing procedures, insurance claims, and reimbursement processes.

Familiarity with CPT, ICD-10, and HCPCS coding. Understanding of Medicare billing guidelines and requirements. Experience working with electronic health records (EHR) or practice management systems. Strong attention to detail, organizational skills, and ability to manage high-volume workloads. Ability to identify and resolve billing errors independently.

Strong written and verbal communication skills.

Preferred Qualifications

Experience using Next. Gen for medical billing or charge entry. Experience billing Medicare RPM and CCM services. Familiarity with medical claim edits, denials, and corrections. Experience in a high-volume healthcare billing environment. Medical billing or coding certification, such as CPC, CPC-A, CCS, or RHIT. Ideal Candidate The ideal candidate is a dependable, detail-oriented medical billing professional who understands the importance of accurate claims processing and timely reimbursement.

They are comfortable working in a fast-paced environment, have strong problem-solving skills, and can efficiently manage billing responsibilities while maintaining accuracy and compliance. Salary $23 - $25 per hour