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Billing Specialist

Location : Miami
Job Type : Direct
Hours : Full Time
Required Years of Experience : 3+
Travel : No
Relocation : No
Job Industry : Healthcare - Health Services
Job Category : Healthcare - Social Services/Mental Health

Job Description :

Our client in Southern Miami-Dade County, is seeking an experienced Billing Specialist for an immediate Full-time, (W2 employee) opportunity.

You will be part of a prestigious nationally accredited and fully integrated non-profit health system. Compensation is commensurate with experience inclusive of a full suite of Health benefits.


·         Medical claim review, recommendation of alternate or additional codes to ensure proper billing, analyzing and assisting in the correction of rejected claims, and secondary submission of claims.

·         Monitor Interfaces related to charges and demographics in association with PM applications. Complete and coordinate corrections/updates.

·         Prioritize and complete incoming requests via ChangeGear.

·         Maintain PM billing support files including, insurance plans, provider files, service files, fees schedules and profiles, diagnosis codes, procedure codes, and ERA parameters.

·         Participate in Vendor conference calls as touchpoints to identify opportunities for system optimization

·         Participate in development, generation and Quality Assurance of analytical information supporting financial, encounter and Quality based reporting measures.

·         Research and testing of POMIS system tools and parameters assisting with defining and development.

·         Develop documentation supporting training initiatives in POMIS application.

·         Develop documentation for member centers associating required system actions in accordance with payor and/or software updates.

·         Keeps current with payor billing/payment rules, EDI tools and EDI transaction requirements

·         Execute daily financial closing


Required Qualifications :

Must possess:

·         Strong customer service skills

·         Knowledge of UB04 billing, electronic claims processing, CPT & ICD9/10, HCPCS, CDT   coding, medical terminology and compliance rules

·         Solid knowledge of Microsoft Office Suite

·         Billing and accounts receivable systems

·         Healthcare contract terms, preferably for primary care, vision, dental and/or behavioral health

·         FQHC billing experience


·         Associate’s Degree in Accounting, Finance, MIS, Healthcare Administration, Business Administration or related field.

·         Minimum of 3 years’ healthcare billing and collection experience.

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