Medical Billing Specialist Job at Edwards Electronic Processing in Orlando

JOB DESCRIPTION
Job Description
We are a growing medical billing agency located in Orlando, seeking an experienced Medical Billing Specialist to join our team.
The ideal candidate will be well-versed in the full healthcare revenue cycle, including charge posting, payment posting, claims follow-up, insurance verification and patient statement processing.. This is not a remote position.
A minimum of 3 years of medical billing or healthcare office experience is required.
We are a collaborative, client-focused team dedicated to delivering outstanding customer service.
Candidate must have experience working the full claim cycle in a revenue cycle management system.
Key Responsibilities:
Claims Management: Clean, scrub, and submit electronic and paper claims to various insurance carriers.
Denials & Appeals: Identify root causes for claim denials and draft compelling clinical and administrative appeals to secure payment.
When necessary, call insurance carriers to verify reasons for denial or ask for claims to be reprocessed.
Verification of Benefits (VOB): Proactively verify patient insurance coverage, including deductibles, co-pays, and plan limitations.
Prior Authorizations: At client request, request needed authorizations, track requested authorizations, and process approvals as they come in.
If authorizations are denied, coordinate and communicate with clients promptly.
Client Communication: Act as a professional point of contact for provider offices, offering clear updates on claim status, answering questions, and providing excellent customer service
AR Follow-up: Monitor aging reports and persistently follow up with payers on outstanding or underpaid claims.
Patient Invoicing: Review patient invoices for accuracy before sending out.
Communicate with patients and providers regarding patient balances
Post payments: Post electronic and manual remittances, handling denials and exceptions/holds as needed.
Insurance / Patient Credit Balances Research insurance and patient credit balances and try to resolve through client or insurance communication, or voids/replacement claims.
Compliance: Maintain strict adherence to HIPAA regulations and stay updated on the latest ICD-10, CPT, and HCPCS coding guidelines.
Focus on team success: Ensure you are a proactive and positive member of a team by assisting team members as needed or in their absence.
Other duties as assigned Work tasks assigned via the task management system, but other duties may be assigned to ensure success and completion of the revenue cycle management process.
Qualifications:
• Strong attention to detail with the ability to multitask effectively
• Solid understanding of CPT, ICD-10 codes, and appropriate use of modifiers
• Experience billing commercial insurance, Medicare, and Medicaid
• Familiarity with medical terminology, especially related to insurance and benefits
• Typing speed of 50+ WPM and proficiency with 10-key
• Excellent verbal and written communication skills
• Previous experience with therapy billing is a plus, but not required
• Ability to work well in a team-oriented, collaborative environment
If you're a motivated billing professional who thrives in a team setting and is committed to accuracy and service excellence, we’d love to hear from you!