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

emhsangycU14cTdveDAveU5EN3dNS1JZL3c9PQ==
  • 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, Remote job,

Similar Jobs

ICON

Clinical Research Associate Job at ICON

 ...As a Clinical Research Associate you will be joining the worlds largest & most comprehensive clinical research organisation, powered by healthcare...  ...~ BS/BA in Scientific or relevant discipline OR 5 years' experience in Clinical Research ~ RN/Nursing expeirence required... 

Delta Health Center

Dental Assistant Job at Delta Health Center

 ...Position Title: Dental Assistant Location: Delta Health Center, Inc. Multiple locations (Greenville/Mound Bayou/Mobile Unit) Job Type: Full-Time Reports To: Dental Director About Delta Health Center, Inc.: Delta Health Center (DHC), located in... 

Acorns

Social Media Manager Job at Acorns

 ...tools of wealth-making into everyones hands. ___________________________________________________________________________ Social Media Manager | Acorns How we show up online matters. Acorns is seeking a Social Media Manager who thrives on creating bold, engaging... 

National Health Partners

Plastic Surgery - Treasure Coast, Florida Job at National Health Partners

 ...Plastic and Reconstructive Surgeon on Floridas Atlantic Coast Treasure Coast, Florida This area, known as the Treasure Coast gem...  ...Qualifications: Completion of an accredited Plastic Surgery training program Advanced training in microsurgery Preferably... 

Assurity Transportation Solutions

Owner Operator CDL A Truck Driver Home Daily Job at Assurity Transportation Solutions

 ...~ Owner Operator position ( 88% true money to you home daily local positions ( these positions fill fast, 4-6k weekly avg, for Home...  ...general freight, no touch to you ~ You can Pre-booked loads if you want ~ Driver referral bonuses Potential to earn way more!!...