Billing & Collection Specialist

Whole Family Health Center Inc; Florida; On-site; USD 50,000 - 70,000; Full time

Job summary

Whole Family Health Center Inc is hiring a Billing and Collections Specialist in Fort Pierce, FL. The role focuses on Medicare, Medicaid, local contracts, and self-pay, ensuring accuracy per CMS and payer guidelines.

You will handle eligibility checks and patient inquiries while maintaining timely filing and collections strategies. The position requires strong communication skills; bilingual abilities (English/Spanish or Creole) are a plus but not mandatory.

Qualifications

• Minimum three years of medical billing and coding experience.
• Two years of self-pay and third-party collections experience.
• Experience with insurance eligibility verification and payer guidelines.

Responsibilities

• Ensure charges are dropped daily for Athena processing.
• Monitor dashboards and claims worklists to ensure timely filing and follow-up.
• Review denial reports and escalate trends for process improvement.
• Verify eligibility for special contracts (e.g., Ryan White).
• Ensure monthly claims submission adheres to payer guidelines.
• Review patient appointments for eligibility before visits and assist with resolution.
• Answer patient billing questions and perform data entry of monthly lab charges.
• Update patient accounts based on sliding fee eligibility.
• Support travel between locations as needed.

Skills

Communication skills

Bilingual

Education

High School Diploma or GED

College degree preferred

Billing and coding certification preferred

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

FullTime Fiscal & Bill Staff Admin South, Fort Pierce, FL, US

3 days ago Requisition ID: 1388

Billing and Collections Specialist

The person in this position will work independently dealing with Medicare, Medicaid, local contracts, commercial insurances, and self-pay patients in accordance with CMS, AHCA, HRSA, and payer guidelines.

Communication

Good oral and written communication skills are required for this position. The information must be exchanged using tact and persuasion appropriately. The person in this position must be able to communicate with the patients, staff, and others; and contribute to a positive environment. Bilingual English Spanish, or Creole preferred, but not required.

Key Responsibilities

• Ensure charges are dropped daily for Athena processing.


• Monitor’s work-flow dashboards and claims worklists to ensure claims follow up in accordance with timely filing and appeal guidelines.


• Review denial management reports and identifies trends and opportunities for process improvement elevates to Business Services Manager for discussion and action plans.


• Special Contract billing and eligibility verification (Ryan White, Project Response, etc.)
  
  
  
  • Ensures monthly claims submission guidelines are in adherence with payer requirements.
  
  
  
  


• Review appointment schedules for insurance eligibility prior to appointments and assist with resolution prior to the scheduled time.


• Answers call and help patients with insurance and billing questions.


• Data entry of monthly lab charges


• Review and update patient accounts based on sliding fee eligibility.


• Other duties and responsibilities as assigned.


• May occasionally need to travel from one location to another.

Education & Training

• High School Diploma or GED required


• A college degree is preferred but not required


• Certification in billing and coding preferred

Experience

• Minimum three (3) years of experience in medical billing and coding


• Minimum two (2) years experience with self-pay and third-party collections

Requirements

• Level 2 background clearance required


• Proof of immunizations for (1) Tdap, (2) MMR’s, HEP B vaccination, and either a history of chickenpox (varicella) or documentation of the varicella vaccine, a PPD Test is done once upon hire (if applicable to the position)

WFHC reserves the right to change or modify the job description, including but not limited to Major Responsibilities, Education, Certification, and Physical Requirements.