Billing Specialist

Job not on LinkedIn

🕒 August 4

🐊 Florida – Remote

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⏰ Full Time

🟡 Mid-level

🟠 Senior

📊 Billing Specialist

👻 Ghost score 24%

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Logo of Coral Connect

Coral Connect

2 - 10 employees

Founded 2021

🤲 Charity

🌍 Social Impact

Charity • Social Impact

Coral Connect is an innovative platform that connects donors to coral reef conservation efforts. It showcases the growth, health, and progress of each charitable impact, increasing transparency and donor engagement around reef restoration and protection.

📋 Description

• Review patient accounts for billing readiness and verify required documentation, authorizations, and charges • Prepare and submit professional, facility, infusion, and pharmacy claims to payers within filing deadlines • Validate HCPCS, J-Codes, CPT, ICD-10, modifiers, units, and place of service codes • Bill infusion therapies, specialty pharmacy claims, and home infusion services according to payer and regulatory requirements • Monitor claim transmission reports, clearinghouse edits, payer edits, adjudication responses, and rejections • Research, correct, and resubmit rejected claims within established turnaround times • Coordinate with pharmacy teams regarding prescription, dispensing, reimbursement, and coordination of benefits • Verify prior authorizations and clinical documentation support billed services • Review charges for accuracy and completeness, identify missing charges, and support revenue integrity • Collaborate with intake, prior authorization, cash posting, accounts receivable, clinical, pharmacy, RCM, and client teams • Participate in client meetings, quality assurance audits, training, special projects, and process improvement initiatives • Maintain HIPAA and billing-regulation compliance, detailed billing documentation, and adherence to company procedures

🎯 Requirements

• High School Diploma or GED required • Minimum 1 year of healthcare billing experience preferred • Experience in infusion services, specialty pharmacy, physician billing, hospital outpatient billing, or home infusion preferred • Experience with Medicare, Medicaid, and commercial insurance billing preferred • Experience with infusion-specific reimbursement methodologies preferred • Strong understanding of medical billing and reimbursement processes • Knowledge of HCPCS, J-Codes, CPT, ICD-10, modifiers, and payer billing requirements • Understanding of infusion drug reimbursement and administration billing • Familiarity with specialty pharmacy billing and adjudication processes • Knowledge of claim submission, claim edits, and rejection management • Strong attention to detail and accuracy • Excellent organizational and time management skills • Proficiency with EMR, practice management, and billing software systems • Intermediate Microsoft Excel skills • Ability to travel on a limited basis to client locations, internal business meetings, and other locations as needed • Ability to maintain HIPAA and applicable billing-regulation compliance

🏖️ Benefits

• Health insurance • Dental insurance • Vision insurance • Life insurance • 401k • Paid Time Off

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