Remote Pediatric Therapy Medical Billing Specialist

The JOY FM; North Augusta (GA); Hybrid; USD 42.000 - 66.000; Teilzeit

Zusammenfassung

Made for More Pediatric Clinic is expanding its billing operations in Evans, GA, seeking an experienced Medical Billing Specialist or Billing Consultant with outpatient pediatric therapy experience. This role supports transitioning to insurance billing, building processes, and training staff.

The position offers flexible arrangements (remote, hybrid, or in-office) and could develop into a longer-term role as the clinic grows. Strong knowledge of CPT/ICD-10 and HIPAA is essential.

Qualifikationen

• Previous experience with medical insurance billing and claims management.
• Knowledge of CPT codes, ICD-10 codes, insurance reimbursement, and claims processing.
• Experience with commercial insurance payers, including Aetna, BCBS, UnitedHealthcare, and others.
• Familiarity with eligibility verification, prior authorizations, denials, and appeals.
• Strong organizational skills, attention to detail, and ability to work independently.
• Understanding of HIPAA and patient confidentiality requirements.
• Preferred: experience billing outpatient pediatric speech, occupational, and physical therapy services; CPC/CPB certification.

Aufgaben

• Establishing and maintaining insurance billing workflows within our electronic medical record system.
• Assisting with insurance payer setup, EDI/ERA enrollment, and electronic claims processing.
• Verifying patient insurance eligibility, benefits, and coverage requirements.
• Identifying and managing referrals, prior authorizations, and other payer-specific requirements.
• Reviewing and submitting accurate claims for speech, occupational, and physical therapy services.
• Monitoring claim submissions, identifying rejections, resolving denials, and submitting appeals when necessary.
• Posting insurance payments, reviewing explanations of benefits (EOBs), and reconciling electronic remittance advice (ERA).
• Managing outstanding accounts receivable and following up on unpaid or underpaid claims.
• Assisting with patient billing and financial responsibility.
• Developing written billing procedures, checklists, and internal workflows.
• Providing guidance and training to clinic leadership and designated staff members to support long-term billing operations.

Kenntnisse

Medical billing

HIPAA compliance

Independent work

Payer knowledge

EMR proficiency

Ausbildung

Medical billing certification (CPC/CPB)

Tools

Prompt EMR

Availity

Electronic claims clearinghouses

Jobbeschreibung

Made for More Pediatric Clinic is expanding its billing operations in Evans, GA, seeking an experienced Medical Billing Specialist or Billing Consultant with outpatient pediatric therapy experience. This role supports transitioning to insurance billing, building processes, and training staff.

The position offers flexible arrangements (remote, hybrid, or in-office) and could develop into a longer-term role as the clinic grows. Strong knowledge of CPT/ICD-10 and HIPAA is essential.