Senior Medical Billing Executive

Description

In this position, the Senior Medical Billing Executive works diligently to verify insurance eligibility, obtain prior authorizations, and prepare claims for submission with precision. The role requires strong skills in accounts receivable follow-up, analyzing aging reports, managing denials, pursuing necessary appeals, and reconciling payments efficiently. Proficiency in electronic health records (EHR) and electronic medical records (EMR) systems, billing software, and payer portals is crucial. The executive manages multiple client accounts, resolves complex billing issues, and meets productivity targets while fostering clear communication and coordination with clients and internal teams. This role does not involve team management but demands a proactive approach and excellent analytical capabilities.

Responsibilities

• Verify insurance coverage, perform eligibility checks, and secure prior authorizations for medical procedures and services.
• Submit accurate and timely claims to Medicare, Medicaid, Medicare Advantage, and commercial insurance payers using correct coding standards including CPT, ICD-10, and HCPCS.
• Manage claim denials and rejections by analyzing reasons and taking appropriate corrective actions to recover payments.
• Conduct accounts receivable follow-up activities by reviewing aging reports, contacting payers, and resolving outstanding balances.
• Analyze denial trends and develop strategies to reduce the frequency of denials and improve cash flow.
• Prepare and submit appeals for denied claims, ensuring that all necessary documentation and information meet payer requirements.
• Reconcile payments against submitted claims to ensure accuracy and completeness of revenue.
• Utilize and maintain proficiency in EHR and EMR systems, billing software, payer portals, and electronic remittance advice (ERA) processing.
• Handle multiple client accounts simultaneously while maintaining accuracy and meeting productivity standards.
• Communicate effectively with insurance providers, healthcare staff, and clients to resolve billing discrepancies and provide updates on claim statuses.
• Maintain compliance with medical coding guidelines and regulatory requirements to minimize audit risks and improve reimbursement accuracy.
• Organize and prioritize workload efficiently to meet deadlines and achieve departmental goals.

Experience

3 Years

Apply By

Dec 11, 2026

Required Skills

• 3+ years of experience in US medical billing or healthcare RCM
• Strong knowledge of Medicare, Medicaid, Medicare Advantage, and commercial insurance
• Expertise in claim submission, denial management, rejection handling, and AR follow-up
• Familiarity with CPT, ICD-10, HCPCS, EOBs, ERAs, and payer portals
• Expertise in insurance verification, eligibility checks, and prior authorizations
• Strong experience in AR follow-up, aging reports, denial analysis, appeals, and payment reconciliation
• Proficiency in EHR/EMR systems, billing software, payer portals, and medical coding guidelines
• Ability to handle multiple client accounts, resolve complex billing issues, and meet productivity targets

Nice to Have Skills

• Excellent communication, problem-solving, and organizational skills
• Analytical Skills
• Team Coordination skills