Job Description
Job DescriptionWe are looking for a skilled Medical Billing Specialist to join our team in Lauderdale Lakes, Florida. In this long-term contract position, you will play a vital role in ensuring the accuracy and efficiency of medical billing processes across various healthcare settings. This role requires a strong background in collections and medical billing, with experience in nursing home or hospital billing preferred.
Responsibilities:
• Process commercial and managed care claims using specialized billing software, ensuring all data is accurately edited and reconciled.
• Monitor and follow up on outstanding claims over 30 days, resolving them efficiently while utilizing accounts receivable aging reports.
• Prepare detailed accounts receivable spreadsheets for assigned payers and participate in monthly review meetings with leadership.
• Manage detailed trial balances for accounts receivable, ensuring timely submission of claims, proper documentation, and compliance with payer contracts.
• Investigate and resolve denied claims, including clinical denials, through appeals processes while identifying trends and root causes.
• Submit appeals to payers within specified timelines, ensuring compliance with all requirements.
• Collaborate closely with facility departments such as admissions, case management, and medical records to support effective revenue cycle management.
• Identify and address systemic issues causing delays or underpayments, and recommend solutions to improve payment processes.
• Maintain proficiency in multiple systems and processes to support departmental operations and cross-functional knowledge.• Proven experience in medical billing and collections, with a focus on nursing home or hospital billing preferred.
• Familiarity with billing software such as Allscripts, Cerner Technologies, and Dynamic Data Exchange (DDE).
• Proficiency in electronic health record (EHR) systems and platforms like Epaces.
• Strong knowledge of accounts receivable management, including appeals and claim administration.
• Ability to handle billing functions efficiently, ensuring compliance with policies and payer contracts.
• Expertise in resolving medical claims and collections issues.
• Excellent communication skills to collaborate effectively with internal teams and external payers.
• Strong analytical skills to identify trends and systemic issues impacting revenue cycle performance.