Medical Billing Specialist

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to support a healthcare organization in Boca Raton, Florida on a Contract basis. This position focuses on coding accuracy, billing compliance, and reimbursement optimization through careful review of documentation and claims activity. The ideal candidate brings strong experience in E/M coding and auditing, along with the ability to work closely with providers and billing teams to improve accuracy and resolve reimbursement issues.

Responsibilities:

• Conduct secondary reviews of billing activity to confirm compliance with regulatory standards, internal procedures, and reimbursement guidelines.
• Examine clinical documentation and coded services to identify missed charges, under coding, over coding, or other discrepancies, and document findings in clear audit reports.
• Partner with physicians and clinical staff to clarify incomplete or unclear documentation and promote accurate coding and billing practices.
• Escalate recurring documentation concerns, coding patterns, and compliance risks to revenue cycle leadership or practice management for follow-up.
• Collaborate with billing and revenue cycle teams to support account resolution, including claim corrections, resubmissions, and follow-up tied to accounts receivable performance.
• Evaluate payer reimbursement behavior, fee schedule outcomes, denial trends, and policy changes to identify opportunities for improved revenue capture.
• Research and address questions related to coding compliance, payer requirements, denials, and appropriate billing for services rendered.
• Deliver education, guidance, and ongoing support to providers and staff on coding standards, documentation expectations, and regulatory requirements.
• Help maintain compliant billing procedures, charge tools, and related workflows while safeguarding confidential financial and medical information