Billing Specialist

• Oversee day-to-day operations of the billing team, including workflow management, staffing, training, and disciplinary actions
• Coordinate billing needs and onboarding processes for newly acquired centers and DeNovo facilities
• Monitor payment trends and implement billing and collections strategies to improve cash flow
• Ensure HIPAA compliance across billing activities and implement regulatory updates
• Work with payers to resolve complex billing or reimbursement issues
• Collaborate with Operations to align billing requirements across facilities
• Ensure timely month-end close processes and billing department reporting
• Monitor and optimize the patient account to staff ratio
• Escalate reimbursement or payment issues to the VP of RCM
• Contribute to and monitor adherence to the departmental budget
• Oversee and continuously improve billing processes and systems
• Develop and implement staff training programs
• Conduct staff evaluations, set performance goals, and manage individual development plans
• Promote professional development through leadership coaching, mentorship, and regular performance audits
• Foster collaboration across the organization to improve efficiency and outcomes
• Serve as a communication bridge between executive leadership and frontline billing staff
• Address and resolve employee relations issues

Billing Manager

• Process third-party billing, claim resolution, and adjudication
• Manage FFS and PPS billing
• Conduct census balancing and payor verification
• Verify insurance and Medicaid coverage
• Apply knowledge of Dual Coverage, MCR D, and Commercial Plans pertaining to Long Term Care
• Assist with customer billing inquiries in a courteous and professional manner
• Enter fees and charges in Framework LTC
• Prepare daily, weekly, and monthly pre-bills and account audits
• Prepare daily, weekly, and monthly reports
• Create statements and end-of-month summaries
• Understand and work with residents on account balances
• Follow all applicable government regulations, including HIPAA
• Perform other duties as deemed necessary by the Billing Manager

• Upload behavioral health claims accurately and timely in the electronic claims processing system.
• Ensure claims follow State, Federal, Contractual, and Agency standards.
• Verify member eligibility, benefit limits, and authorizations.
• Ensure standard billing practices are met for claim adjudication.
• Send accurate explanations of benefits to providers.
• Develop and maintain strong working relationships with providers.
• Respond to claims inquiries by phone, fax, and mail.
• Respond to audits within the timeframe specified by the manager.
• Execute assignments independently while maintaining compliance with facility policies, contract requirements, organization bylaws, and federal and state regulations.

Billing Specialist jobs in Florida

Billing Manager

Billing Specialist

Billing Coordinator