Senior Medical Billing Specialist

• Lead outbound calls to insurance companies and payors to collect comprehensive information, including claim statuses, detailed denial reasons, payment discrepancies, and any required follow-ups.

• Build and maintain professional relationships with external stakeholders to facilitate timely resolution of complex billing issues.

• Ensure all communication is conducted in full compliance with client guidelines, healthcare regulations (e.g., HIPAA), and industry best practices.

Data Management, Categorization, and Reporting

• Independently manage accurate recording, categorization, and labeling of data using client-defined taxonomy, ensuring alignment across teams.

• Identify gaps or inconsistencies in data categorization and proactively propose improvements to enhance reporting quality and analysis efficiency.

• Prepare and deliver detailed, structured reports and dashboards to the client at agreed frequencies, highlighting key trends and potential risks.

Advanced Call Transcript Analysis & Process Optimization

• Review and analyze recorded call transcripts to extract actionable insights, identify denial trends, systemic issues, and patterns impacting claim outcomes.

• Synthesize findings into comprehensive reports and present recommendations for process enhancements, contributing to the continuous improvement of billing and collection workflows.

• Collaborate closely with internal teams and client representatives to implement agreed process changes and measure their effectiveness.

Mentorship & Knowledge Sharing

• Provide guidance and support to junior team members in best practices for calling, data labeling, and analysis.

• Contribute to the development of internal training materials and knowledge bases.

• Minimum of 2 years of experience in medical billing, insurance claims, or a related field.
• Strong English proficiency, both verbal and written.
• Familiarity with healthcare regulations and industry guidelines.
• Excellent communication skills with the ability to make outbound calls to insurance companies and payors.
• Detail-oriented and able to maintain accurate records.
• Ability to work independently while adhering to internal guidelines and procedures.
• Proficiency in Microsoft Office Suite or similar software; experience with medical billing software is a plus.