Medical Billing Specialist

VIVA USA Inc; Florida; On-site; USD 40,000 - 52,000; Full time

Job summary

VIVA USA Inc. is seeking a Billing and Compliance Specialist onsite in Florida to ensure HIPAA-compliant processing of client information, verify insurance, and communicate co-pay responsibilities to clients.

The role requires timely submission of claims, handling front-end and back-end denials, posting payments, and maintaining accurate records. You will support operations and coordinate with payers and referral sources to keep billing workflows efficient.

Qualifications

• HIPAA and PHI regulatory compliance required.
• Experience processing claims and coordinating payments.
• Ability to verify insurance and collect co-pays.
• Attention to data accuracy and timely data entry.

Responsibilities

• Ensure compliant processing of client information across systems.
• Coordinate insurance verification and explain client’s co-pay responsibilities.
• Submit claims in a timely manner and resolve front-end/back-end denials.
• Post cash accurately and follow up on outstanding payments.
• Maintain up-to-date reimbursement information and guidelines.
• Provide customer service support: processing, resolving, and logging inquiries.

Skills

Front-end denials

DME experience

Job description

Responsibilities:

• Assures that all phases of processing client information are in compliance with HIPAA, PHI regulatory and related policies and practices.
• Reports any Compliance issues to the Director of Operations.
• Coordinates the insurance verification process and makes sure that the client understands their co-pay responsibility.
• Responsible to follow-up as necessary to facilitate the collection of co-pays.
• When applicable may gather credit card or other payment processing information from client and enters into system to process payment for account.
• Manages the entry of client information into computer system in a timely manner and contact of referral source, customer, and/or client to obtain missing information needed to set up client for service.
• Ensures that the data is accurate and complete.
• Confirms all sales orders in the system and ensures that all required information (e.g. proof of delivery, signed prescription, signed acknowledgement form, etc.) is on file before submitting claim for payment.
• Follows up on all missing sales orders and reconciles billing questions on a regular basis until payment status is complete.
• Responsible for the timely submission of claims (electronic and paper as needed) to payers;
• Corrects and resubmits front-end and back-end rejected claims.
• Ensures that all cash is posted to the correct account in a timely manner.
• Responsible for the timely follow-up and collection of payments due to the organization.
• This is accomplished by generating invoices and/or following up with clients and/or payers.
• Uses available resources to maintain current regulatory guidelines and reimbursement information to ensure that the company is obtaining all appropriate information as required for billing and reimbursement.
• Performs other duties/projects as assigned by management including customer service support: processing, resolving, and logging customer inquiries

Top Skills:

• Looking for someone with experience in working front end rejections.
• Someone that has previous DME experience

Notes:

• 100% onsite
• Work Hours: Monday-Friday, 8am-4:30pm EST

VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status