Medical Biller

Job Description

Job Description

Medical Billing Specialist – ABA & Speech Therapy

Location: Waldorf, Maryland
Position: Part-Time
Work Arrangement: On-Site

We are seeking an experienced Medical Billing Specialist to join our growing pediatric healthcare organization. This is a part-time, on-site position for a billing professional with experience in rehabilitative and habilitative healthcare services, including ABA and Speech Therapy.

This is not an entry-level billing position. We are looking for someone who can step into the role with minimal training, manage day-to-day billing responsibilities, identify issues before they impact reimbursement, and actively work outstanding claims through resolution.

Key Responsibilities

• Submit accurate and timely claims for ABA and Speech Therapy services
• Verify insurance eligibility, benefits, authorizations, and coverage requirements
• Review claims for accurate CPT/HCPCS codes, units, provider information, and authorization requirements
• Monitor claim status and follow claims through payment or resolution
• Review EOBs and ERAs and identify payment discrepancies
• Work denied, rejected, underpaid, and outstanding claims
• Submit corrected claims, reconsiderations, appeals, and supporting documentation when necessary
• Monitor accounts receivable and aging reports and actively work outstanding balances
• Identify trends in denials and billing errors and communicate issues to leadership
• Reconcile services rendered, clinical documentation, authorizations, and claims to identify missing or incorrect billing
• Monitor timely filing requirements and payer-specific billing guidelines
• Identify billing issues related to provider enrollment, credentialing, authorization, or eligibility
• Communicate with insurance companies regarding claim status, denials, authorizations, and reimbursement issues
• Maintain accurate billing records and documentation
• Collaborate with clinical, administrative, and leadership teams to resolve billing and documentation issues

Required Experience

Qualified candidates should have hands-on experience with:

• Professional medical billing and claims management
• Rehabilitative and/or habilitative healthcare billing
• ABA and/or Speech Therapy billing
• Medicaid and commercial insurance
• Insurance verification and eligibility
• Prior authorizations
• Denial management and appeals
• EOB/ERA review
• Accounts receivable and aging claims
• Corrected claims and claim resubmissions
• Electronic medical records and billing systems

Qualifications

• Previous professional medical billing experience required
• Experience with therapy-based healthcare billing strongly preferred
• Knowledge of Medicaid and commercial payer requirements
• Strong understanding of the complete revenue cycle from service delivery through reimbursement
• Ability to identify and troubleshoot billing discrepancies independently
• Excellent attention to detail and organizational skills
• Strong communication and problem-solving skills
• Ability to prioritize aging claims and meet billing deadlines
• Ability to work independently while communicating billing concerns and trends to leadership

What We're Looking For

The ideal candidate does more than submit claims. We are looking for someone who takes ownership of the billing cycle, understands why claims are not paying, knows what action needs to be taken, and follows issues through resolution.

You should be comfortable reviewing an aging report, investigating outstanding claims, identifying patterns in denials, communicating with payers, and escalating operational or clinical issues that are preventing reimbursement.

This is a part-time, on-site position in Waldorf, Maryland.