Medical Billing and Insurance Specialist
Location: Reston, VA 20190
Employment Type: Full-Time
Work Arrangement: On-Site
Schedule: Monday–Friday, 7:30 AM–4:30 PM
Compensation: $26–$30 per hour, based on experience
Experience Required: Minimum 3 years of medical billing experience
Position Overview
We are seeking an experienced, detail-oriented Medical Billing and Insurance Specialist to join our fertility center in Reston, Virginia.
The ideal candidate has prior medical billing experience in a fertility clinic or reproductive medicine practice. Candidates with OB/GYN billing experience are also strongly encouraged to apply.
This position is responsible for insurance verification, prior authorizations, medical billing, claims processing, payment posting, accounts receivable management, patient financial counseling, and collections. The role also provides administrative support to ensure efficient daily operations and a positive patient experience.
Key Responsibilities
Medical Billing and Insurance
- Verify patient insurance eligibility, coverage, and benefits.
- Obtain prior authorizations for medical services and procedures.
- Post daily charges and prepare, submit, and mail insurance claims as needed.
- Retrieve Explanation of Benefits (EOBs) and Electronic Funds Transfer (EFT) information from insurance portals.
- Accurately post insurance payments to patient accounts.
- Investigate and resolve unpaid, rejected, or denied insurance claims.
- Generate and review accounts receivable aging reports.
- Contact insurance carriers to follow up on outstanding claims and payments.
- Maintain accurate billing records and documentation.
Patient Financial Services and Collections
- Meet with patients to explain insurance coverage, financial responsibilities, and available payment options.
- Prepare, print, and mail patient billing statements.
- Follow up on outstanding patient balances and coordinate collection activities.
- Refer delinquent accounts exceeding 120 days past due for collections, in accordance with office procedures.
- Assist with collection-related court proceedings when required.
- Maintain accurate pricing sheets and patient financial records.
Administrative and Operational Support
- Process incoming mail and prepare bank deposits.
- Answer incoming calls and assist with appointment scheduling.
- Maintain accurate patient billing and financial records.
- Support other administrative and office functions as needed.
Requirements
Minimum Qualifications
- At least 3 years of medical billing experience.
- Experience with insurance eligibility verification, claims processing, prior authorizations, payment posting, and collections.
- Working knowledge of medical insurance billing procedures, reimbursement processes, and accounts receivable management.
- Experience communicating with insurance carriers to resolve unpaid or denied claims.
- Proficiency with medical billing software, electronic health records, and insurance portals.
- Strong organizational skills, attention to detail, and ability to manage multiple responsibilities.
- Excellent communication and interpersonal skills, particularly when discussing financial matters with patients.
- Ability to work on-site in Reston, VA, Monday through Friday, 7:30 AM–4:30 PM.
- Must be legally authorized to work in the United States without employer sponsorship, now or in the future
Preferred Qualifications
- Previous medical billing experience in a fertility clinic, reproductive endocrinology practice, or reproductive medicine setting.
- Medical billing experience in an OB/GYN practice.
- Familiarity with fertility treatment coverage, insurance authorizations, and patient financial counseling.
- Experience using Lytec medical billing software.
Benefits
Hourly Compensation: $26–$30 per hour, depending on experience and qualifications.
Benefits Include:
- Health Insurance: Employer-provided health insurance coverage for the employee only, effective after the first 90 days of employment.
- Vacation: 10 days of vacation.
- Sick Leave: 5 sick days, accrued at approximately one day every 2.5 months.
- Paid Holidays: 5 major holidays.
- 401(k) Retirement Plan: Eligibility after one year of employment.
- Profit Sharing: Profit-sharing plan with a five-year vesting schedule