Hospital Billing & Claims Specialist

Professional Physical Therapy

. Submit accurate institutional (UB-04) and professional (CMS-1500) claims to commercial and government payers .

Posted 9/19/2026full-timeMelville • New York • United StatesMid-LevelSenior💰 $24 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in submitting and managing institutional (UB-04) and professional (CMS-1500) claims, ensuring compliance with payer policies and regulations while maintaining high productivity and quality standards. Proficient in utilizing the Raintree EMR system to resolve billing issues and enhance operational efficiency.

Highest-signal resume keywords

Revenue Cycle ManagementUB-04 BillingCMS-1500 BillingRaintree EMR ProficiencyClaim Resolution

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Institutional BillingProfessional BillingClaim SubmissionClaim Edits ResolutionPatient Eligibility VerificationBilling ReviewCharge EntryClaims ProcessingCompliance with HIPAAPayer Policies Knowledge

Soft Skills

Analytical SkillsOrganizational SkillsProblem-Solving SkillsAttention to DetailCustomer Service

Tools & Technologies

DOL PortalClaim Connect PortalRaintree EMR System

Industry Keywords

Medical BillingRevenue CycleCommercial InsuranceGovernment InsuranceBilling Guidelines

About the role

Key responsibilities & impact

Submit accurate institutional (UB-04) and professional (CMS-1500) claims to commercial and government payers
Review and resolve claim edits, billing errors, clearinghouse exceptions, and rejections
Submit corrected claims and ensure successful claim transmission to payers
Verify patient eligibility and resolve coverage or demographic discrepancies prior to claim submission
Communicate with insurance carriers, patients, providers, and internal teams to resolve billing issues
Complete billing reviews, post splint charges, and enter charges into the DOL and Claim Connect portals
Monitor claims processing inboxes and follow up on outstanding clearinghouse responses
Navigate the Raintree EMR system to resolve claim issues and document account activity
Meet departmental productivity and quality standards while maintaining compliance with HIPAA and other applicable regulations
Stay current on payer policies and billing guidelines
Perform other duties and special projects as assigned

Requirements

What you’ll need

3+ years of Revenue Cycle or medical billing experience
Strong knowledge of institutional (UB-04) and professional (CMS-1500) billing
Experience with commercial and government insurance payers
Proficiency with the Raintree EMR system
Strong analytical, organizational, and problem-solving skills with exceptional attention to detail
Proven ability to manage multiple priorities, work independently, and consistently meet productivity goals
Cross-functional Revenue Cycle experience is a plus
Commitment to professionalism, teamwork, confidentiality, and excellent customer service

Benefits

Comp & perks

2 weeks PTO
Sick time in accordance with state and local requirements
6 major holidays
Company-matched 401(k) once eligibility requirements are met
Pre-tax transit and parking benefits through WageWorks for eligible in-office employees
MetLife Pet Insurance with flexible plans, up to 90% reimbursement on eligible expenses, and 24/7 telehealth support
Exclusive discounts through PlumBenefits and LifeMart on travel, entertainment, shopping, dining, and more