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AI Summary

The Billing Specialist I manages daily medical billing activities, including claims submission, payment posting, and resolving billing discrepancies. They also maintain professional communication with insurance companies, patients, and clinic staff to ensure accurate and timely reimbursement.

Description

Makovicka Physical Therapy is seeking a detail-oriented and dependable Billing Specialist I to join our centralized billing team supporting our growing network of 22 physical and occupational therapy clinics.


The Billing Specialist I will be responsible for day-to-day medical billing activities, including claims processing, payer correspondence, account follow-up, payment posting, and resolving routine billing issues. This position works closely with clinic staff, patients, insurance companies, and members of the billing team to help ensure accurate and timely reimbursement.


Position Summary

The ideal candidate is organized, detail-oriented, comfortable working with insurance companies, and able to manage multiple priorities in a fast-paced healthcare environment. Previous medical billing experience is preferred, particularly experience with physical therapy, occupational therapy, or other outpatient healthcare services.


Work Environment

After successful completion of in-office training at our Corporate office, this will be a remote position supporting the centralized billing operations of a 22-clinic physical and occupational therapy organization.


Because this role supports multiple clinics, strong communication, responsiveness, and the ability to work independently are essential.


Essential Responsibilities

Claims & Billing

· Prepare, review, and submit electronic and paper insurance claims.

· Review claims for accuracy and completeness prior to submission.

· Monitor claim status and follow up on outstanding claims.

· Research and resolve claim rejections, denials, and billing errors.

· Correct and resubmit claims as necessary.

· Process insurance and patient payments accurately.

· Post payments, adjustments, and contractual write-offs according to established procedures.

· Review accounts receivable and follow up on outstanding balances.

· Assist with identifying and correcting billing discrepancies.

· Verify insurance information and assist with resolving eligibility or coverage issues.

· Maintain accurate billing documentation and account notes.

· Process secondary and tertiary claims when applicable.

· Assist with authorization and referral-related billing issues.


Insurance & Email Correspondence

· Communicate with insurance companies regarding claims, benefits, payments, denials, and account questions.

· Respond to billing-related emails from clinics, insurance representatives, patients, and other members of the organization.

· Maintain professional and timely written communication.

· Document payer and patient communications in the appropriate systems.

· Escalate complex payer issues or recurring problems to the appropriate billing team member.


Patient Accounts

· Assist patients with questions regarding insurance balances, statements, payments, and account activity.

· Provide clear and professional explanations of billing and insurance processes.

· Direct complex financial or clinical questions to the appropriate department.

· Maintain patient confidentiality and comply with HIPAA and organizational privacy policies.


General Billing Responsibilities

· Work assigned billing queues and accounts according to established productivity and quality standards.

· Assist with monthly and periodic billing projects.

· Identify trends in denials, rejections, and payment issues and communicate concerns to leadership.

· Follow established billing policies, payer requirements, and organizational procedures.

· Assist other members of the billing department as needed.

· Perform other duties related to medical billing and revenue cycle operations as assigned.


  What We Offer

· Remote work environment after successful completion of in-office training

· Collaborative billing and administrative team

· Opportunity to grow within a multi-clinic healthcare organization

· Training and ongoing professional development

· Meaningful role supporting patient care and clinic operations

· Competitive compensation and benefits package


Requirements

Qualifications

Required:

· High school diploma or equivalent.

· Strong attention to detail and organizational skills.

· Ability to manage multiple tasks and meet deadlines.

· Strong written and verbal communication skills.

· Ability to work independently as well as part of a team.

· Proficiency with computers, email, Microsoft Office, and electronic systems.

· Ability to maintain confidentiality and handle protected health information appropriately.


Preferred:

· 1+ year of medical billing or healthcare revenue cycle experience.

· Experience with insurance claims and payer portals.

· Experience with outpatient physical therapy, occupational therapy, or other healthcare billing.

· Familiarity with Medicare, Medicaid, commercial insurance, workers' compensation, and/or auto/liability claims.

· Experience with an electronic medical record or practice management system.

· Familiarity with CPT, ICD-10, insurance terminology, and common medical billing practices.

  

Skills & Attributes

We are looking for someone who is:

· Detail-oriented – catches errors before they become billing problems.

· Organized – effectively manages multiple accounts, tasks, and deadlines.

· Persistent – follows claims and outstanding balances through resolution.

· Professional – communicates effectively with patients, payers, and coworkers.

· Team-oriented – works collaboratively with a centralized billing and clinic team.

· Problem-solving – able to research an issue and determine the appropriate next step.

· Adaptable – comfortable learning new software, processes, and payer requirements.

· Accountable – takes ownership of assigned work and follows through.


OSHA Category:

There is limited or no potential for exposure to blood borne pathogens.





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