Administrative & Medical Billing Specialist

Salary Range: $23.00 To $25.00 Hourly

Job Description

Administrative & Medical Billing Specialist

Pediatric Speech Lab (PSL)
Location: Waldorf, Maryland
Employment Type: Full-Time | 40 Hours Per Week
Work Arrangement: On-Site
Rate: $23.00-$25.00/hour

Pediatric Speech Lab (PSL) is seeking a highly organized, dependable, and proactive Administrative & Medical Billing Specialist to support the administrative, billing, insurance, and operational functions of our growing ABA and pediatric speech therapy programs.

This in-clinic position combines administrative and clinical duties, designed for someone with strong administrative and medical billing skills.

The ideal candidate will have experience with medical billing, insurance claims, authorizations, accounts receivable, scheduling, and healthcare administration
, preferably within ABA, speech therapy, pediatric, rehabilitative, or habilitative healthcare settings.

This is not an entry-level billing position
. The successful candidate should be able to work independently, identify billing and authorization issues, follow outstanding claims through resolution, and communicate effectively with leadership, insurance companies, families, and clinical staff.

The position requires the ability to transition between administrative and billing responsibilities.

• $23.00-$25.00/hour
• Full-time position:
  40 hours per week
• Standard company benefits
• Aflac benefits available
• 401 K

• Submit accurate and timely claims for ABA and Speech Therapy services.
• Verify insurance eligibility, benefits, coverage requirements, and authorization requirements.
• Review claims for accurate CPT/HCPCS codes, units, provider information, and authorization requirements.
• Monitor claim status and follow claims through payment or resolution.
• Review EOBs and ERAs and identify payment discrepancies.
• Work denied, rejected, underpaid, and outstanding claims.
• Submit corrected claims, reconsiderations, appeals, and supporting documentation when necessary.
• Monitor accounts receivable and aging reports and actively work outstanding balances.
• Identify trends in denials, rejected claims, and billing errors.
• Communicate billing concerns and trends to leadership.
• Reconcile services rendered, clinical documentation, authorizations, and claims to identify missing or incorrect billing.
• Monitor timely filing requirements and payer-specific billing guidelines.
• Identify billing issues related to provider enrollment, credentialing, authorization, eligibility, or documentation.
• Communicate with insurance companies regarding claim status, denials, authorizations, and reimbursement issues.
• Maintain accurate billing records and supporting documentation.
• Assist with billing-related questions from families and staff.
• Research payer requirements and assist leadership in resolving recurring reimbursement issues.

• Track ABA and Speech Therapy insurance authorizations.
• Obtain and maintain required authorizations.
• Monitor authorization expiration dates and initiate renewals before services are interrupted.
• Verify insurance eligibility and benefits.
• Communicate with insurance companies regarding authorization and coverage requirements.
• Identify potential authorization issues that could result in non-payment.
• Communicate authorization concerns to clinical and administrative leadership.

• Create, maintain, and adjust ABA therapy schedules for clients and therapists.
• Coordinate therapist availability and ensure appropriate coverage.
• Manage schedule changes related to cancellations, staffing, and client needs.
• Communicate schedule changes promptly to staff and families.
• Assist with maintaining accurate client and provider schedules.
• Identify scheduling issues that may affect authorized services or reimbursement.

• Assist with onboarding new clients and creating client profiles.
• Collect and maintain required intake and insurance documentation.
• Serve as a professional point of contact for parents and caregivers regarding scheduling, administrative questions, and billing matters.
• Communicate appointment confirmations, cancellations, rescheduling, and general clinic announcements.
• Assist families with billing-related questions and direct more complex concerns to leadership when appropriate.
• Provide professional, compassionate, and responsive customer service.

• Enter and update…