Medical Billing & Insurance Specialist - High-Dollar Claims & Inpatient Billing (Hybrid, Full-Time) - 240427 Job at Medix™, Baltimore, MD

Tys1RFdqZ00xOTZGbDhDVldLOVN4SXFBT3c9PQ==
  • Medix™
  • Baltimore, MD

Job Description

Job Overview

We are seeking an experienced Medical Billing & Insurance Specialist with a strong background in high-dollar hospital claims, Medicare Exhaust cases, and inpatient facility billing. This role requires expertise in handling complex claims exceeding $100K in Maryland and $500K in Washington, DC, working with UB-04 billing, and managing Coordination of Benefits (COB) conflicts. The ideal candidate will have extensive experience in hospital revenue cycle management, insurance appeals, and payer dispute resolution.

The position offers a full-time hybrid schedule, working four days remotely and one day in the office after the training period. All employees are required to work onsite 5 days a week for training purposes (first 3-4 months).

Key Responsibilities

  • Handle high-dollar inpatient facility claims, ensuring proper billing and reimbursement for accounts exceeding $100K in Maryland and $500K in Washington, DC.
  • Process and follow up on Medicare Exhaust claims, COB denials, and other complex inpatient billing cases.
  • Investigate and resolve insurance claim denials, including appeals for underpayments, non-covered services, and coordination of benefits issues.
  • Work directly with insurance companies and hospital billing systems to ensure claims are processed accurately and paid timely.
  • Analyze payer trends to identify reimbursement issues and recommend corrective action.
  • Complete daily UB-04 billing and ensure compliance with hospital reimbursement policies.
  • Meet performance benchmarks for claims resolution, denials management, and high-dollar claim collections.

Required Qualifications

  • Must have experience handling high-dollar hospital accounts exceeding $100K in Maryland and $500K in Washington, DC.
  • Extensive knowledge of Medicare Exhaust claims, inpatient billing, and Coordination of Benefits processes.
  • Strong experience with UB-04 billing for inpatient and hospital-based claims.
  • Minimum one to two years’ experience in hospital patient accounting, medical billing, or revenue cycle management.
  • Proficiency in hospital billing systems such as Epic, Cerner, Meditech, and Microsoft Excel and Word.
  • Ability to resolve complex payer issues and follow up on unpaid claims.
  • Excellent communication, problem-solving, and organizational skills.

Job Type & Schedule

  • Full-time hybrid position with four days remote and one day in the office.
  • All employees are required to initially work onsite 5 days a week for training purposes (first 3-4 months).

If you meet the qualifications, apply today to make an impact in hospital revenue cycle operations!

Job Tags

Full time,

Similar Jobs

Airgas

Carrier Program Manager Job at Airgas

 ...We are hiring! Airgas is Hiring for a Carrier Program Manager in Independence, OH! At Airgas, we RESPECT, HONOR and VALUE diversity. We...  ...loyalty. Hybrid Schedule: 3 days in the office and 2 days remote Excellent Benefits: Airgas offers a full benefits package... 

Jetty Healthcare

Healthcare Recruiter (Commission-Only, Remote) Job at Jetty Healthcare

 ...to keep healthcare teams running smoothly. Jetty Healthcare is trusted by large health systems. Role Description This is a part-time, remote, commission-only, role at Jetty Healthcare. The Healthcare Recruiter will be responsible for tasks such as healthcare... 

LHH

Legal Assistant Job at LHH

 ...LHH Recruitment Solutions is partnering with a growing law firm in the downtown Pittsburgh area to find a highly administrative, client service oriented candidate. This role would be to support the attorneys in the corporate transactional group. Responsibilities... 

International Leadership of Texas

Facilities Technician (High School) Job at International Leadership of Texas

 ...Transports goods or equipment as assigned Performs immediate cleaning duties necessary to maintain clean facility. Assist Custodial Crew when needed to benefit the campus. Performs other maintenance duties as assigned by the Facilities Director Responsible for... 

LHH

Call Center Representative Job at LHH

 ...1:30 AM - 8 PM (remote after training) Do you excel in a call center environment? LHH Recruitment Solutions is seeking dedicated and...  ...and Prime. Qualifications: Prior, recent call center experience is required. Strong communication skills and a customer-centric...