Medical Billing Specialist

3 weeks ago


Gainesville, United States Blue Star Partners LLC Full time
Job DescriptionJob Description

Job Title: Medical Billing Specialist
Location: Gainesville, FL – Onsite – Local candidates only
Period: 05/10/2024 to 12/16/2024 - possibility of extension
Hours/Week: 40 hours
Rate: $23-$25/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.


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