Medical Billing Specialist

Little Angels PPEC and One World Pediatrics is seeking a detail-oriented and experienced Remote Medical Billing Specialist to manage billing, credentialing, and prior authorization processes for our multi-location pediatric therapy and care services. This position starts as part-time, with the potential to transition into full-time based on performance and business needs. The ideal candidate will ensure accurate insurance claims processing, maximize revenue collection, and maintain compliance with industry regulations.

Key Responsibilities

Medical Billing & Collections

• Submit and track insurance claims for PPEC, physical therapy, occupational therapy, and speech therapy services.

• Review and reconcile insurance payments, denials, and appeals to optimize collections.

• Monitor accounts receivable and follow up on outstanding claims to reduce denials and improve cash flow.

• Ensure compliance with HIPAA, Medicaid, Medicare, and private insurance regulations.

Credentialing & Prior Authorizations

• Manage provider credentialing and re-credentialing with various insurance payers.

• Maintain up-to-date provider enrollment and contracts with Medicaid and commercial insurance plans.

• Obtain prior authorizations for all therapy and medical services, ensuring timely approvals.

• Communicate with insurance representatives, providers, and patients regarding coverage and authorization issues.

Revenue Cycle Management & Reporting

• Analyze reimbursement trends and suggest strategies for improving revenue collection.

• Generate financial reports detailing collections, denials, and revenue trends.

• Collaborate with the administrative team to implement billing policies and procedures that enhance efficiency.

How to Apply:

• Interested candidates should submit a resume and a brief cover letter outlining their relevant experience and qualifications.

• This is a great opportunity for an experienced medical billing professional looking for flexibility and growth in a remote role with a performance-based compensation structure.

Requirements

• Experience: Minimum 2 years in medical billing, preferably in PPEC or therapy-related services.

• Knowledge: Strong understanding of Medicaid, Medicare, and commercial insurance billing and credentialing.

• Software Proficiency: Experience with medical billing software and electronic health record (EHR) systems.

• Detail-Oriented: Ability to process claims accurately and efficiently to minimize denials.

• Communication: Strong verbal and written communication skills for interacting with insurance companies and providers.

• Problem-Solving: Ability to resolve claim denials and credentialing issues effectively.

Benefits

• Salary is performance-based at 1.5% of total insurance collections, estimated at $3M in annual revenue.

• Growth potential as collections increase.

Work Schedule & Flexibility:

• Part-time to full-time remote position with flexible hours.

• Must be available for periodic meetings and follow-ups during business hours.