Medical Billing Specialist

About us

Eccolab Group, Co. is a licensed, independent full-service clinical laboratory headquartered in Miami, Florida, with additional facilities in Tampa. Established in 2001, we provide comprehensive analytical services to a diverse clientele, including hospitals, skilled nursing facilities, assisted living centers, and research organizations. With a strong focus on accuracy, innovation, and client education, we are committed to improving patient outcomes through fast, reliable diagnostics and cutting-edge laboratory technologies. Our team upholds the highest standards in quality assurance, compliance, and customer service. Visit us at for more information.

Job Summary

The Medical Billing Specialist is responsible for managing the billing process from claim generation to payment posting, ensuring timely and accurate submission of claims to insurance providers. This role involves reviewing, correcting, and resubmitting claims as needed, handling denials and appeals, and maintaining communication with insurance companies and patients to ensure reimbursement. The ideal candidate is detail-oriented, experienced in healthcare billing, and well-versed in insurance protocols and revenue cycle practices.

The medical Billing Specialist plays a key role in safeguarding the financial health of Eccolab Group by managing the full lifecycle of patient billing and insurance reimbursement. This position is responsible for ensuring that all claims are submitted accurately, payments are collected in a timely manner, and outstanding balances are resolved effectively. The role requires exceptional customer service skills to communicate with patients, providers, and insurance representatives in a professional and empathetic manner. By combining technical expertise in billing and coding with strong problem-solving and interpersonal skills, the medical Billing Specialist reduces revenue loss, minimizes claim denials, and ensures compliance with payer and regulatory requirements. This position is essential in maintaining steady cash flow and supporting the organization's commitment to delivering high-quality clinical laboratory services.

Scope

The Medical Billing Specialist operates within the Accounting & Revenue Cycle Departments and serves as a critical link between patients, insurance providers, and internal departments. This role focuses on maintaining accurate insurance and patient records, verifying benefits and eligibility, and ensuring that billing practices meet industry standards. The scope extends to claims processing, payment posting, appeals management, collections, and supporting internal audits. The medical Billing Specialist also collaborates with laboratory staff, customer service, and finance to ensure billing accuracy and compliance with HIPAA, Medicare, Medicaid, and commercial payer regulations, while promoting transparency and efficiency in revenue cycle operations. This position plays a critical role in the financial cycle of the laboratory by ensuring accurate billing and timely reimbursement for services rendered. The specialist will work closely with the clinical, administrative, and accounting teams to resolve discrepancies and uphold billing compliance standards.

Essential Duties/Responsibilities

• Review medical records, lab requisitions, and patient bills to ensure accuracy, completeness, and compliance with payer and regulatory requirements.
• Prepare, submit, and track electronic and paper claims to Medicare, Medicaid, and commercial insurance providers.
• Monitor aging reports, identify unpaid or underpaid claims, and follow up promptly to ensure timely reimbursement.
• Investigate, research, and appeal denied or rejected claims, ensuring thorough documentation and resolution.
• Post insurance and patient payments accurately and reconcile accounts using Explanation of Benefits (EOBs).
• Verify patient insurance eligibility, benefits, and medical necessity prior to claim submission.
• Identify and process secondary and tertiary insurance billing as applicable.
• Communicate professionally with patients, providers, and insurance representatives to resolve billing inquiries and discrepancies.
• Work collaboratively with third-party payers, clearing houses, and internal departments to resolve claim or payment issues.
• ·Maintain accurate patient and provider records in compliance with HIPAA and company policies.
• Audit billing data regularly to identify errors, inconsistencies, or compliance risks, and implement corrective actions.
• Prepare and assist with billing and revenue cycle performance reports to support accounting and financial reviews.
• Recommend and assist in implementing process improvements to enhance billing accuracy, workflow efficiency, and reduce claim denials.
• Coordinate with laboratory and administrative teams to ensure billing aligns with service documentation and testing procedures.
• Support internal audits, financial reporting, and process improvement initiatives within the Accounting and Revenue Cycle Departments.
• Stay current with changes in billing regulations, payer requirements, and coding practices.

Qualifications

• Minimum of 3 to 5 years of progressive, hands-on billing experience within a clinical laboratory, diagnostic testing, or healthcare environment.
• Associate's degree in healthcare administration, Medical Billing, Accounting, or a related field required; Bachelor's degree preferred.
• Certification in Medical Billing and Coding required (CPB, CPC, or CCS preferred).
• Bilingual (English and Spanish) required, with strong written and verbal communication skills.
• Proven expertise in billing and reimbursement for high-volume laboratory testing, including molecular, pathology, and toxicology services.
• Demonstrated experience managing full-cycle billing for Medicare, Medicaid, and commercial insurers, including appeals, denials, and reimbursement follow-up.
• Strong knowledge of payer regulations, CPT/ICD coding, EOB reconciliation, and compliance standards (HIPAA, CMS, and OIG).
• Proficiency in billing and accounting software systems; experience with laboratory information systems (LIS) and clearinghouses preferred.
• Ability to analyze billing data, identify trends, and implement corrective actions to optimize revenue recovery.
• Commitment to ongoing professional development through continuing education in billing, compliance, and laboratory-specific coding.

Skills/Abilities

• In-depth knowledge of medical billing, collections, and reimbursement practices within healthcare and laboratory environments.
• Strong understanding of CPT, HCPCS, ICD-10/11 coding systems, payer rules, and insurance reimbursement protocols.
• Demonstrated proficiency in billing software and accounting platforms, including experience with Microsoft Office Suite, Kareo, AdvancedMD, or similar systems.
• Advanced ability to review and interpret EOBs, resolve denials, and manage appeals efficiently and accurately.
• Exceptional analytical and problem-solving skills with the ability to identify issues, research solutions, and implement process improvements.
• Strong attention to detail, accuracy, and organizational skills to manage multiple billing accounts simultaneously.
• Excellent verbal and written communication skills to interact professionally with patients, insurance representatives, and internal teams.
• Proven ability to prioritize tasks, meet deadlines, and perform effectively in a high-volume, fast-paced environment.
• Demonstrated commitment to confidentiality, compliance, and adherence to HIPAA and OSHA regulations.

Key Requirements

• Authorized to work in the U.S. with valid I-9 documentation.
• Available for extended hours, weekends, or holidays as needed (If required)
• Subject to background check and drug screening per Florida law.
• Completion of HIPAA and OSHA training upon hire; ongoing compliance required.
• Adherence to HIPAA, FIPA, and all confidentiality regulations.
• Compliance with Florida Department of Health and CDC safety protocols.
• Professional appearance and conduct required in a clinical setting.
• Willing to perform additional duties as assigned.

Job Types: Full-time, Contract

Pay: $ $25.00 per hour

Expected hours: No more than 40 per week

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Ability to Commute:

• Miami, FL Required)

Ability to Relocate:

• Miami, FL 33144: Relocate before starting work (Required)

Work Location: In person