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. This contract position focuses on coding accuracy, billing compliance, and reimbursement optimization within a regulated clinical environment. The ideal candidate brings strong experience in E/M coding, documentation audits, and provider education, along with a current coding certification from a recognized credentialing body.

Responsibilities:

• Conduct secondary reviews of billing activity to confirm coding accuracy, regulatory compliance, and appropriate reimbursement outcomes.
• Examine clinical documentation to identify coding discrepancies, including both missed charges and over reported services, and summarize findings in clear audit reports.
• Partner with physicians and other care team members to clarify incomplete or conflicting documentation and support accurate claim submission.
• Escalate recurring documentation or coding concerns to revenue cycle leadership or practice management with recommendations for corrective action.
• Work closely with billing and revenue cycle staff to resolve account issues, support claim corrections, and improve accounts receivable follow-up efforts.
• Evaluate payer reimbursement patterns, fee schedule variances, and denial trends to identify opportunities for process improvement.
• Investigate questions related to payer guidelines, coding compliance, denials, and billable services, and provide informed responses to stakeholders.
• Deliver education, coaching, and ongoing guidance to providers and staff on documentation standards, coding rules, and third-party payer requirements.
• Maintain current knowledge of payer policy updates and communicate relevant changes affecting specialty billing and coding practices.
• Protect the confidentiality of patient records and financial information while completing assigned billing and audit duties.