Heal Precisely
Medical Billing Specialist - Wound Care at Heal Precisely Saint Petersburg, FL
Heal Precisely, St. Petersburg, Florida, United States, 33739
Medical Billing Specialist - Wound Care job at Heal Precisely. Saint Petersburg, FL.
Job Description
About the Company The Billing Specialist – Wound Care is responsible for managing and processing claims related to wound care services, ensuring accurate coding, timely submission, and efficient reimbursement from payers. This role requires in-depth knowledge of medical billing practices, wound care terminology, and payer policies, including Medicare and commercial insurance requirements. About the Role The Billing Specialist – Wound Care is responsible for managing and processing claims related to wound care services, ensuring accurate coding, timely submission, and efficient reimbursement from payers. This role requires in-depth knowledge of medical billing practices, wound care terminology, and payer policies, including Medicare and commercial insurance requirements. Responsibilities Accurately review and process wound care documentation to generate clean claims Submit claims electronically or manually to insurance carriers in a timely manner Ensure appropriate coding using ICD-10, CPT, and HCPCS specific to wound care procedures Work closely with providers and clinical staff to clarify documentation or resolve coding discrepancies Follow up on unpaid or denied claims; perform resubmissions and appeals as necessary Monitor aging reports and maintain established KPIs for claim turnaround time and resolution Verify patient insurance benefits and authorizations for wound care services when required Ensure compliance with HIPAA, payer-specific regulations, and internal billing policies Collaborate with clinical and operations teams to address billing-related issues proactively Assist with month-end reporting, audits, and reconciliation as needed Qualifications High school diploma or equivalent (Associate’s or Bachelor's degree preferred) Minimum 2 years of medical billing experience, preferably in wound care or specialty care settings Strong knowledge of insurance claims processes, coding (CPT, ICD-10, HCPCS), and modifiers Experience with Medicare, Medicaid, and commercial payer guidelines Familiarity with EHR systems and billing software (e.g., Athena, Kareo, AdvancedMD) Proficiency in Microsoft Excel and basic data entry/reporting tools Excellent communication skills and attention to detail Ability to work independently and manage multiple billing priorities Sponsorship This position is not eligible for employment sponsorship (Green Card holders and U.S. Citizen only) Required Skills Certification in medical billing and coding (e.g., CPC, CPB) Prior experience in wound care billing or durable medical equipment (DME) claims Knowledge of documentation requirements for advanced wound therapies Preferred Skills Certification in medical billing and coding (e.g., CPC, CPB) Prior experience in wound care billing or durable medical equipment (DME) claims Knowledge of documentation requirements for advanced wound therapies Pay range and compensation package Competitive salary based on experience Health, dental, and vision insurance 401(k) plan Paid time off and holidays Professional development opportunities Equal Opportunity Statement We are committed to diversity and inclusivity in our hiring practices.
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About the Company The Billing Specialist – Wound Care is responsible for managing and processing claims related to wound care services, ensuring accurate coding, timely submission, and efficient reimbursement from payers. This role requires in-depth knowledge of medical billing practices, wound care terminology, and payer policies, including Medicare and commercial insurance requirements. About the Role The Billing Specialist – Wound Care is responsible for managing and processing claims related to wound care services, ensuring accurate coding, timely submission, and efficient reimbursement from payers. This role requires in-depth knowledge of medical billing practices, wound care terminology, and payer policies, including Medicare and commercial insurance requirements. Responsibilities Accurately review and process wound care documentation to generate clean claims Submit claims electronically or manually to insurance carriers in a timely manner Ensure appropriate coding using ICD-10, CPT, and HCPCS specific to wound care procedures Work closely with providers and clinical staff to clarify documentation or resolve coding discrepancies Follow up on unpaid or denied claims; perform resubmissions and appeals as necessary Monitor aging reports and maintain established KPIs for claim turnaround time and resolution Verify patient insurance benefits and authorizations for wound care services when required Ensure compliance with HIPAA, payer-specific regulations, and internal billing policies Collaborate with clinical and operations teams to address billing-related issues proactively Assist with month-end reporting, audits, and reconciliation as needed Qualifications High school diploma or equivalent (Associate’s or Bachelor's degree preferred) Minimum 2 years of medical billing experience, preferably in wound care or specialty care settings Strong knowledge of insurance claims processes, coding (CPT, ICD-10, HCPCS), and modifiers Experience with Medicare, Medicaid, and commercial payer guidelines Familiarity with EHR systems and billing software (e.g., Athena, Kareo, AdvancedMD) Proficiency in Microsoft Excel and basic data entry/reporting tools Excellent communication skills and attention to detail Ability to work independently and manage multiple billing priorities Sponsorship This position is not eligible for employment sponsorship (Green Card holders and U.S. Citizen only) Required Skills Certification in medical billing and coding (e.g., CPC, CPB) Prior experience in wound care billing or durable medical equipment (DME) claims Knowledge of documentation requirements for advanced wound therapies Preferred Skills Certification in medical billing and coding (e.g., CPC, CPB) Prior experience in wound care billing or durable medical equipment (DME) claims Knowledge of documentation requirements for advanced wound therapies Pay range and compensation package Competitive salary based on experience Health, dental, and vision insurance 401(k) plan Paid time off and holidays Professional development opportunities Equal Opportunity Statement We are committed to diversity and inclusivity in our hiring practices.
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