Billing Specialist I

MERIT HEALTH WESLEY is seeking a Billing Specialist I to manage insurance claim processing, billing, and follow-up, ensuring timely and accurate reimbursement while maintaining compliance with organizational policies and HIPAA regulations.

Submit and process claims accurately according to payer requirements and company policies.

Communicate with insurance companies, patients, and stakeholders to resolve billing inquiries.

Review and reconcile credit balances, reclassify revenue, and process adjustments.

Monitor and resolve claim denials and rejections, identifying trends and implementing corrective actions.

Review and correct claim filing edits based on payer requirements and EHR system alerts.

Maintain accurate documentation of billing actions in the practice management system.

Update and communicate billing policy changes to ensure staff access to current guidelines.

Collaborate with management, clinic staff, and coding teams for proper billing and collections.

Assist patients and insurance representatives with billing-related questions professionally.

Ensure compliance with HIPAA and maintain confidentiality of patient financial and medical information.

Perform other duties as assigned and maintain regular attendance.

0–2 years of experience in medical billing, insurance claims processing, or revenue cycle management.

Knowledge of medical billing processes, insurance claim procedures, and payer policies.

Proficiency with EHR and practice management systems (e.g., Athena, Cerner, Ingenious Med).

Ability to interpret explanation of benefits (EOBs) and resolve billing discrepancies.

Strong analytical, problem-solving, and communication skills.

Attention to detail and ability to manage multiple tasks.

Working knowledge of HIPAA regulations.

Preferred Licenses/Certifications:

CPB – Certified Medical Biller (AAPC) or

Certified Medical Insurance Specialist (CMIS) (PMI)

None