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, undercoding, overcoding, 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

• Current coding certification from AAPC or AHIMA is required.

• At least 5 years of experience in medical billing, coding, collections, revenue cycle support, or a closely related healthcare function.

• Demonstrated hands-on experience with E/M coding is required.

• Strong background in coding audits and documentation review.

• Working knowledge of medical claims processes, reimbursement practices, and compliance standards within a healthcare setting.

• Ability to interpret payer policies, investigate denials, and communicate effectively with providers and administrative teams.

• Experience with medical billing systems and tools, including exposure to ePACES, is preferred.

• Associate degree from an accredited institution is preferred.

• Boca Raton, FL

• remote

• Temporary / Contract

• 24.7 - 28.6 USD / Hourly