Job Description
Job Title: Medical Hospital Billing Specialist
Location: On-site / Hybrid / Remote
Department: Revenue Cycle / Patient Financial Services
Employment Type: Full-Time
Position Summary
The 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 Responsibilities
Prepare, review, and submit hospital claims (inpatient, outpatient, and/or ancillary services) to commercial, Medicare, and Medicaid payers
Verify patient insurance coverage, authorizations, and benefits as needed
Ensure accurate charge capture, coding validation, and modifier usage prior to claim submission
Monitor claim status and follow up on unpaid, denied, or underpaid claims
Research and resolve claim denials, payment variances, and payer rejections
Post payments, adjustments, and contractual allowances accurately
Maintain detailed account notes and documentation in the billing system
Communicate effectively with payers, patients, and internal departments to resolve billing issues
Stay current on payer guidelines, billing regulations, and compliance requirements
Meet productivity and accuracy standards established by the department
Qualifications
High school diploma or equivalent required; associate’s degree preferred
Minimum of [1–3] years of hospital billing experience required
Strong knowledge of hospital billing processes, UB-04 claims, and payer guidelines
Familiarity with CPT, HCPCS, ICD-10 coding concepts
Experience with Medicare, Medicaid, and commercial insurance payers
Proficiency with electronic health records (EHR) and billing systems
Strong attention to detail and analytical skills
Ability to manage multiple priorities and work independently
Excellent written and verbal communication skills
Preferred Qualifications
Experience in inpatient and outpatient hospital billing
Knowledge of denial management and appeals
Familiarity with revenue cycle metrics and AR follow-up workflows
Certification such as CPB, CPC, or equivalent (preferred but not required)
Work Environment & Benefits
Collaborative, fast-paced healthcare environment
Competitive compensation based on experience
Comprehensive benefits package including medical, dental, vision, PTO, and retirement options
Opportunities 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.
