Medical Billing Specialist (IN PERSON - NOT REMOTE)

Qualifications

· The ideal candidate will have a strong background in medical billing.

· Minimum 4 years of experience in medical billing. 2 if in Pediatrics.

· Experience with credentialing and authorizations.

· Knowledge of CPT/ICD-10 coding. Pediatrics preferred.

· Familiarity with Medicaid capitated insurance plans.

· Strong attention to detail and excellent organizational skills.

· Effective communication and interpersonal skills.

· Proficient in billing software and Microsoft Office Suite.

· Bilingual – Fluent in Spanish preferred.

·

Responsibilities - Manage all aspects of billing and Claims Processing:

· Prepare and submit accurate claims to insurance companies

• Review claims for errors and ensure compliance with payer guidelines.

· Claims Submission

· Monitor claim Adjudication

• Follow up on denied claims and implement corrective actions to ensure timely payment

· Payment Posting primary -insurance, patient and TOS payments

· Prepare next responsible party statement / claim submission

· Manage credits and overpayments

· Assist Operations Administrator in the credentialing process, ensuring all necessary documentation is completed and submitted

· Stay informed about changes in insurance requirements and credentialing processes

· Authorization Management: Obtain and manage prior authorizations, ensuring compliance with payer guidelines

· Reporting and Analysis: Generate reports on billing activities, collections, and authorization status

· Analyze data to identify trends and areas for improvement in billing efficiency and revenue cycle management

Job Type: Full-time

Pay: $18.50 - $22.50 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Ability to Relocate:

• Palmetto, FL 34221: Relocate before starting work (Required)

Work Location: In person

Salary : $19 - $23