Medical Billing Specialist

Medical Billing Specialist

Happy Health welcomes applications for the Medical Billing Specialist role.

This range is provided by Happy Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$60,000.00/yr - $70,000.00/yr

The Medical Billing Specialist is responsible for accurate, timely, and compliant revenue cycle execution for our telehealth practice. This role owns key billing workflows including insurance verification support, claims submission, payment posting, accounts receivable follow‑up, and denial management to ensure that patients and payers are billed correctly and revenue is collected efficiently. The ideal candidate has strong medical billing fundamentals, excellent attention to detail, and comfort working in an EHR/practice management system in a fast‑paced environment.

• Support end‑to‑end revenue cycle operations, including insurance verification support, eligibility checks, claims submission, and follow‑up through final resolution.
• Prepare and submit clean claims (professional/telehealth), ensuring accurate coding elements are present and required documentation is attached where applicable.
• Monitor claim status and payer portals; proactively work/monitor rejections, denials, and underpayments in conjunction with our third parties.
• Research, correct, and resubmit claims; submit appeals with supporting documentation as needed.
• Post payments and adjustments, reconcile payments against expected reimbursement, and identify variances.
• Generate patient statements and resolve patient billing inquiries with clarity and professionalism.
• Handle refunds, credit balances, and payment plan workflows in accordance with internal procedures.
• Coordinate with internal teams to resolve payment issues (e.g., failed payments, invoice questions, charge corrections).
• Support provider credentialing and payer enrollment processes as needed for billing continuity (collecting required information, tracking status, maintaining records).
• Help maintain accurate provider and payer setup to prevent claims issues (e.g., NPI, taxonomy, service locations, payor IDs).

• Work within the EHR/practice management system to maintain clean billing workflows (work queues, claim edits, payment posting, reporting).
• Assist with training and documentation for billing workflows (job aids, checklists) and help keep billing processes consistent.
• Track and report key billing metrics (e.g., clean claim rate, denial rate, days in A/R, aging by payer, appeal outcomes); flag trends and root causes.
• Maintain strong data hygiene across patient demographics, insurance information, authorizations (if applicable), and claim details.

• Follow HIPAA and payer compliance requirements; protect PHI and ensure billing actions are auditable.
• Maintain up‑to‑date knowledge of telehealth billing guidelines and payer‑specific rules to reduce denials and delays.

• 4+ years of experience in medical billing / revenue cycle management (telehealth and/or multi‑state billing strongly preferred).
• Hands‑on experience with claims lifecycle: eligibility/verification support, claim submission, payment posting, A/R follow‑up, and denial management.
• Familiarity with CPT/HCPCS/ICD‑10 concepts and common denial types; able to identify missing/incorrect claim elements and resolve.
• Strong fundamental knowledge of how the claims submission using 837
  
  Ps and payment process works across payers.
• Experience working in an EHR/practice management systems; comfortable with work queues and payer portals.
• Strong attention to detail and high accuracy in data entry, claim edits, and payment posting.
• Clear communication skills (written and verbal) for patient billing inquiries, payer follow‑up, and internal coordination.
• Excellent communication and organizational skills with strong attention to detail.
• Ability to manage multiple priorities, meet deadlines, manage timely filing of claims, and work independently in a fast‑paced environment.

• Previous employment at a…