Medical Billing Specialist / Billing Consultant - Pediatric Therapy

Medical Billing Specialist / Billing Consultant – Pediatric Therapy Description About Us: Made for More Pediatric Clinic is a growing pediatric therapy practice located in Evans, Georgia, providing speech therapy services to children and families in our community. Our mission is to provide compassionate, individualized care that helps every child reach their fullest potential. As we expand our services and begin accepting additional insurance plans, we are looking for an experienced medical billing professional to help establish and support our billing operations. Position Overview We are seeking a knowledgeable, detail-oriented, and proactive Medical Billing Specialist or Billing Consultant with experience in insurance billing, preferably within outpatient pediatric therapy. As a growing practice transitioning from private-pay services to insurance billing, we are looking for someone who can help us build a strong foundation, establish efficient processes, and ensure our billing operations are accurate, organized, and compliant. This opportunity is unique in that we are not necessarily looking to fill a traditional full-time position. We are open to working with an experienced professional who can provide ongoing billing support, assist with establishing our billing department, or train internal staff to manage billing responsibilities. Position Type & Flexibility We recognize that experienced medical billing professionals may be looking for different types of opportunities, and we are open to finding an arrangement that works well for both the candidate and our growing practice. This position offers flexibility in scheduling and work location, with remote, hybrid, and in-office arrangements considered based on experience, qualifications, and the needs of the clinic. We are open to several arrangements, including: Part-Time or Contract Position: An ongoing opportunity to manage our billing operations, with the potential for increased hours and responsibilities as our patient volume and practice continue to grow. Short-Term Consulting or Contract Engagement: An opportunity for an experienced billing professional to help establish our insurance billing department, implement efficient procedures, assist with initial claims processing, and train designated staff members to manage billing responsibilities internally. Long-Term Growth Opportunity: For the right candidate, this position could evolve into a more permanent role as our clinic expands. Key Responsibilities Depending on the arrangement and scope of services, responsibilities may include: Establishing and maintaining insurance billing workflows within our electronic medical record system. Assisting with insurance payer setup, EDI/ERA enrollment, and electronic claims processing. Verifying patient insurance eligibility, benefits, and coverage requirements. Identifying and managing referrals, prior authorizations, and other payer-specific requirements. Reviewing and submitting accurate claims for speech, occupational, and physical therapy services. Monitoring claim submissions, identifying rejections, resolving denials, and submitting appeals when necessary. Posting insurance payments, reviewing explanations of benefits (EOBs), and reconciling electronic remittance advice (ERA). Managing outstanding accounts receivable and following up on unpaid or underpaid claims. Assisting with patient billing and financial responsibility. Developing written billing procedures, checklists, and internal workflows. Providing guidance and training to clinic leadership and designated staff members to support long-term billing operations. Qualifications Required Previous experience with medical insurance billing and claims management. Knowledge of CPT codes, ICD-10 codes, insurance reimbursement, and claims processing. Experience with commercial insurance payers, including Aetna, BCBS, UnitedHealthcare, and others. Familiarity with eligibility verification, prior authorizations, denials, and appeals. Strong organizational skills, attention to detail, and ability to work independently. Understanding of HIPAA and patient confidentiality requirements. Preferred Experience billing outpatient pediatric speech, occupational, and physical therapy services. Experience with Prompt EMR. Familiarity with Availity and electronic claims clearinghouses. Experience establishing billing procedures for a new or growing medical practice. Medical billing certification (CPC, CPB, or equivalent). #J-18808-Ljbffr