Billing Specialist

Healthcare Outcomes Performance Co. (HOPCo)

Billing Specialist responsible for managing claim errors in a claims management system for timely insurance submissions. Collaborates with providers and ensures compliance with medical billing standards.

Posted 4/15/2026full-timeRemote • Arizona • 🇺🇸 United StatesJuniorMid-LevelWebsite

About the role

Key responsibilities & impact

Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers.
Review and prepare claims for manual and/or electronic billing submission.
Reviews insurance rejections to determine the next appropriate action steps and obtain the necessary information to resolve any outstanding rejections.
Correct and identify billing errors and resubmit claims to insurance carriers.
Update CAS segments on secondary electronic claims as needed.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Verifies receipt of claim with insurance plans, determining the next appropriate action step.
Researches all information needed to complete the billing process including obtaining information from providers, ancillary services staff, and patients.
Obtains and attaches referrals to appointments/charges.
Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
Identifies and communicates trends and/or potential issues to the management team.
Follows and maintains all HOPCo policies and procedures.

Requirements

What you’ll need

High school diploma/GED or equivalent working knowledge preferred.
Minimum of two to three years of experience in medical billing.
Prior experience working on claim errors in a claims management system preferred.
Strong knowledge of resolution to payor edit reports, and reconciliation of clearinghouse and payor acceptance reports.
Candidates with knowledge of ANSI formatting preferred.
Knowledge of ICD-9, ICD-10, HCPS, and CPT coding, medical terminology, Medicare reimbursement guidelines, billing practices.
Knowledge of government regulatory requirements and commercial contracts.
Advanced computer knowledge, including Window based programs.

Benefits

Comp & perks

Equal Opportunity Employer

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical billingclaims managementbilling submissionbilling error correctioninsurance eligibility verificationICD-9 codingICD-10 codingHCPCS codingCPT codingANSI formatting

Soft Skills

communicationproblem-solvingattention to detailorganizational skillstime management

Certifications

high school diplomaGED