Medical Billing Specialist - Boston, MA
We are currently seeking candidates for a Medical Billing Specialist position with a high performing healthcare organization located in Boston, MA. This role is responsible for ensuring accurate medical coding, timely claims processing, and effective resolution of insurance denials to support the overall success of the revenue cycle. The ideal candidate will have 3+ years of experience in medical coding, billing, and denial management, and must have hands-on experience using the Epic EMR system.

QUALIFICATIONS:

• Bachelor’s degree in related field is preferred
• 3+ years of experience in medical coding and denial resolution
• Proficiency in ICD-9, ICD-10, and Epic EMR system
• Strong knowledge of claims follow-up procedures, insurance appeals, and payer guidelines
• Excellent analytical skills and attention to detail in reviewing codes and claim outcomes
• Effective communication skills for working with cross-functional teams and external payers
• Thorough understanding of healthcare billing processes and regulatory compliance

RESPONSIBILITIES:

• Accurately assign ICD-9 and ICD-10 codes to patient records and insurance claims in compliance with industry and payer standards
• Utilize the Epic Electronic Medical Record (EMR) system to manage and track patient data and documentation
• Investigate and resolve insurance claim denials and rejections through thorough analysis and follow-up
• Collaborate with internal departments including billing, compliance, and clinical teams to address coding discrepancies and documentation gaps
• Engage with major insurance providers to ensure timely claims processing and issue resolution
• Ensure all coding practices adhere to federal regulations, payer guidelines, and internal compliance policies
• Support appeals processes and maintain accurate tracking of denial trends and resolutions