Job Title: Medical Billing Specialist
Location: Gainesville, FL – Onsite – Local candidates only
Period: 12/20/2024 to 04/30/2025 - possibility of extension **
**Hours/Week: 40 hours
Rate: $17-$18/hour (Hours over 40 will be paid at Time and a Half)
Contract Type: W-2
Scope of Services:
The Medical Billing Specialist is a pivotal member of our team, ensuring that the company meets its monthly financial goals. This role requires a diverse skill set and competencies to effectively communicate, negotiate, analyze, and resolve issues with payers and patients while adhering to HIPAA and PHI regulatory requirements.
Role, Responsibilities, and Deliverables:
- Ensure compliance with HIPAA and PHI regulatory policies and practices throughout all phases of client information processing.
- Report any compliance issues to the Director of Operations promptly.
- Coordinate the insurance verification process, ensuring clarity for clients regarding their co-pay responsibilities.
- Facilitate the collection of co-pays through timely follow-up.
- Gather credit card or other payment processing information from clients as necessary and enter it into the system for payment processing.
- Manage the timely entry of client information into the computer system, ensuring accuracy and completeness, and obtain any missing information needed to set up clients for service.
- Confirm all sales orders in the system and ensure that all required documentation (e.g., proof of delivery, signed prescriptions, signed acknowledgment forms) is on file before submitting claims for payment.
- Follow up on missing sales orders and reconcile billing questions regularly until payment status is complete.
- Submit claims (electronic and paper) to payers in a timely manner, correcting and resubmitting front-end and back-end rejected claims as needed.
- Ensure all cash is posted to the correct account promptly.
- Follow up and collect payments due to the organization in a timely manner by generating invoices and following up with clients and/or payers.
- Stay updated on current regulatory guidelines and reimbursement information to ensure accurate billing and reimbursement.
- Perform other duties/projects as assigned by management, including customer service support, processing, resolving, and logging customer inquiries.
Key Skills and Competencies:
- Attention to detail, ensuring accuracy in all tasks.
- Excellent communication and listening skills.
- Proficient in documenting accounts with detail and critical thinking.
- Ability to read an explanation of benefits (EOB).
- Strong analytical skills for effective collections management.
- Familiarity with various tools and systems used in medical billing.
- Proven problem-solving skills to overcome challenges in the billing process.
- Exceptional customer service skills to maintain positive relationships with customers and payers.
- Effective time management to prioritize tasks and meet deadlines.
- Excellent attendance record.
Education & Experience:
- Minimum of 2 years of experience in medical billing or related field.
- Proficiency in medical billing software systems such as [insert specific software names].
- Demonstrated understanding of HIPAA and PHI regulatory requirements.
- Experience in coordinating insurance verification processes and managing co-pay collections.
- Proven track record of accurately entering and managing client information in computer systems.
- Familiarity with claim submission processes and experience in correcting and resubmitting rejected claims.
- Strong communication skills with the ability to effectively interact with clients, payers, and internal teams.
- Prior experience in handling customer inquiries and providing excellent customer service.
- Ability to work independently and as part of a team in a fast-paced environment.
- Previous training or certification in medical billing or related field is a plus.