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Billing Clerk / Specialist
Boca Raton, FL
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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 overreported 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.