Medical Billing Specialist

1 day ago

Orlando, Florida, United States Select Source International Full time

Overview
The Medical Billing Specialist is responsible for end-to-end billing operations, insurance verification, claim submission, reimbursement follow-up, and compliance with HIPAA/PHI regulations.

Responsibilities

  • Ensure all billing activities comply with HIPAA, PHI regulations, and internal policies; report compliance issues to the Director of Operations.
  • Coordinate insurance verification and clearly communicate co-pay responsibilities to clients.
  • Facilitate collection of co-pays and process payments when needed, including gathering credit card information securely.
  • Enter client information accurately and promptly into the system and obtain missing documentation from referral sources or clients.
  • Confirm all sales orders in the system and ensure required supporting documents (e.g., proof of delivery, signed prescription, signed acknowledgment forms) are on file prior to claim submission.
  • Investigate and reconcile missing sales orders and resolve billing discrepancies until payment status is finalized.
  • Submit claims (electronic and paper) in a timely manner; correct and resubmit rejected claims.
  • Ensure all cash applications are posted accurately and promptly to the correct accounts.
  • Conduct timely follow-up and collection of outstanding payments from clients and payers by generating invoices and initiating follow-up communication.
  • Stay current on regulatory guidelines and payer reimbursement requirements to ensure proper billing compliance.
  • Support customer service activities including addressing, resolving, and logging customer inquiries.
  • Perform additional duties and special projects as assigned by management.

Qualifications & Requirements
Must-Have

  • Prior experience in medical billing, insurance verification, or revenue cycle operations.
  • Strong understanding of HIPAA and PHI compliance requirements.
  • Experience with claim submission, denial resolution, and payment posting.
  • Ability to analyze billing issues and follow up with clients, referral sources, and payers.
  • Strong data entry accuracy and attention to detail.
  • Excellent communication, customer service, and organizational skills.
  • Ability to work fully onsite during scheduled business hours.

Preferred

  • Experience working with durable medical equipment (DME) billing or home health billing.
  • Familiarity with payer portals, billing software, or EMR systems.
  • Knowledge of Medicare, Medicaid, and commercial payer requirements.
  • Ability to handle high-volume invoicing and multi-task effectively.
  • Experience managing payment collections and financial counseling.

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