Medical Billing Specialist

Medical Billing Specialist

Integrated Sleep Care, a Pivotal Health Company

📍 Saginaw, MI

🕒 Full-Time | Onsite | Monday-Friday, 8:00 AM-5:00 PM

Join Our Team

Integrated Sleep Care, a Pivotal Health Company, is committed to improving lives through exceptional sleep medicine services and patient-centered care. We are seeking an experienced Medical Billing Specialist to join our growing Revenue Cycle team in Saginaw, Michigan.

This role is ideal for a medical billing professional who enjoys the day-to-day management of claims, payment posting, insurance follow-up, denial resolution, appeals, and accounts receivable. The successful candidate will be highly organized, detail-oriented, and comfortable working directly with insurance carriers, patient accounts, and reimbursement processes to ensure timely and accurate payment for services rendered.

This is a hands-on medical billing position. While a working knowledge of medical terminology, ICD-10 diagnoses, CPT procedures, and payer guidelines is important, this is not a medical coding role.

Position Summary

The Medical Billing Specialist is responsible for the daily execution of billing and accounts receivable activities, including claim submission, payment posting, insurance follow-up, denial management, collections, and account resolution. This role plays a critical part in maintaining the financial health of the organization through accurate billing practices and timely reimbursement.

Key Responsibilities

Medical Billing & Insurance Follow-Up

• Submit, monitor, and follow up on insurance claims for physician and sleep medicine services.
• Review claims for accuracy and completeness prior to submission.
• Work directly with insurance carriers to resolve claim errors, denials, rejections, and reimbursement delays.
• Research underpayments, outstanding balances, and unpaid claims.
• Prepare and submit corrected claims, appeals, and reconsideration requests when necessary.
• Ensure timely filing compliance with payer requirements.
• Maintain accurate documentation of billing activity and account follow-up efforts.

Payment Posting & Reconciliation

• Accurately post insurance and patient payments using EOBs and ERAs.
• Process payments received through electronic remittance, ACH, credit card, and check transactions.
• Reconcile payments with billing records and supporting documentation.
• Research and resolve unapplied payments, posting discrepancies, and payment variances.
• Process approved contractual adjustments, refunds, and write-offs.
• Assist with monthly reporting and account reconciliations.

Accounts Receivable & Collections

• Monitor aging reports and prioritize accounts requiring action.
• Contact insurance companies regarding outstanding claims and reimbursement issues.
• Perform professional patient collections and assist with payment arrangements when appropriate.
• Resolve patient account questions and billing concerns professionally and promptly.
• Maintain detailed account notes and collection documentation.

Compliance & Collaboration

• Maintain compliance with HIPAA and all applicable regulatory requirements.
• Support internal and external audit requests as needed.
• Collaborate with providers, clinical staff, and revenue cycle leadership to resolve billing issues.
• Protect the confidentiality of patient and financial information at all times.

Qualifications

Education & Experience

• High School Diploma or GED required.
• Associate degree in Healthcare Administration, Medical Billing & Coding, Business, Accounting, or a related field preferred.
• Minimum of two (2) years of medical billing, accounts receivable, healthcare collections, or revenue cycle experience required.
• Physician practice, specialty practice, or sleep medicine billing experience preferred.

Required Knowledge

• Medical billing and accounts receivable processes
• Insurance claims processing and reimbursement workflows
• Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) review
• Medicare, Medicaid, and commercial payer guidelines
• Denial management and insurance follow-up
• Patient billing and collections
• General understanding of ICD-10, CPT, and HCPCS codes sufficient to identify billing discrepancies and communicate with providers and payers

Technical Skills

• Experience working within electronic health records (EHR) and medical billing systems.
• Proficiency in Microsoft Office, including Excel.
• Ability to navigate payer portals and electronic claims systems.
• Strong data entry, reconciliation, and account review skills.
• Ability to manage billing work queues and aging accounts efficiently.

Professional Skills

• Excellent attention to detail and accuracy.
• Strong communication and customer service skills.
• Ability to organize and prioritize multiple responsibilities.
• Strong analytical and problem-solving abilities.
• Ability to work independently and collaboratively within a team environment.
• Commitment to delivering high-quality work and exceptional service.

Preferred Qualifications

• Certified Professional Biller (CPB) or similar certification preferred.
• Experience with denial management and appeals.
• Sleep medicine, pulmonary, respiratory, or other specialty practice billing experience.
• Familiarity with payer portals and electronic claims management platforms.

What We're Looking For

The ideal candidate is a hands-on medical billing professional who enjoys working claims from submission through payment. You are comfortable researching denied claims, contacting insurance carriers, resolving reimbursement issues, posting payments, and managing outstanding accounts receivable balances.

You understand medical terminology and healthcare reimbursement processes, but your primary focus is ensuring accurate billing and timely collections rather than coding medical records.

Why Join Integrated Sleep Care?

At Integrated Sleep Care, a Pivotal Health Company, we believe exceptional patient care starts with exceptional team members. Join a growing organization where your expertise directly contributes to improving patient outcomes while working alongside dedicated healthcare professionals in a collaborative and supportive environment.

Equal Employment Opportunity

Integrated Sleep Care, a Pivotal Health Company, is an Equal Opportunity Employer. We are committed to fostering an inclusive workplace and providing equal employment opportunities to all qualified applicants regardless of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected status under applicable law.

E-Verify Employer – All applicants must be legally authorized to work in the United States.