Medical Biller

Medical Billing Specialist

We are partnering with a premier specialty medical group to find a detail-oriented Medical Billing Specialist for a temp-to-hire opportunity. In this role, you will be a vital member of the revenue cycle management team, overseeing the billing process to ensure accurate claim submissions and full payment collection. This is a high-functioning team environment that values proactive communication and a positive attitude. If you are a motivated professional looking to bring patient accounts to a zero balance while working for a company that offers an incredible benefits package, we want to hear from you. Our client offers 100% premium health & dental benefit coverage for the employee, PTO, and life insurance.

Duties and Responsibilities:

• Claims Management: Analyze and resolve rejected claims, ensuring accurate coding and modifiers per payer policies. Review and address rejected claims within a five-day window.

• Appeals Process: Research, prepare, and submit detailed appeals for denied or underpaid claims. Draft justification letters supported by medical documentation and payer policies.

• Denials and Adjustments: Independently analyze claim denials and take corrective action, including corrected claims and reconsiderations. Apply accurate adjustments based on insurance guidelines and contracts.

• Accounts Receivable: Manage secondary insurance and patient responsibility. Create monthly A/R reports and work toward a goal of maintaining days in A/R at 35 or less.

• Internal Collaboration: Work with insurance verification and front desk teams to correct registration errors. Coordinate with charge entry personnel to optimize claim processing and resubmission.

• Patient Interaction: Communicate professionally with patients regarding balances and assist in collecting payments.

Experience and Qualifications:

• Professional Experience: Minimum of 2 years of experience as a medical billing specialist. If you have 5+ years of medical billing experience you would potentially qualify for the senior medical billing role at a higher wage.

• Technical Skills: Proven track record in A/R follow-up, EDI management, medical coding, and medical terminology.

• Certifications: CPC or CPB certification is preferred (or a willingness to obtain certification within 2 years).

• Software Proficiency: Familiarity with AthenaPractice, Encoda, or Phreesia is preferred.

• Industry Knowledge: Knowledge of Florida Medicaid billing is a bonus. Experience in orthopedics or pediatrics is helpful but not required.

• Quality Standards: Ability to maintain high standards of work with accurate and timely processing to avoid adjustments due to past timely filing.

Compensation / Pay Rate (Up to): $22.00 - $28.00

All compensation and pay rates are dependent upon skills and experience. PrideStaff is an equal opportunity employer.