Medical Billing Clerk - Entry Level

Remote Full-time
Work Location: Remote (Florida)

Schedule: M-F (Flexible Hours)

OUR COMPANY: Spark Pediatrics is the leading provider of PPEC Medical Daycare in the country. We provide critical care to hundreds of children and families daily.

Our mission at Spark Pediatrics is to deliver exceptional and compassionate care to our pediatric patients. We believe in building strong partnerships with patients, families, physicians, and referral sources to create personalized treatment plans based on each child's unique needs.

We recognize the challenges of caring for a child with complex medical needs. Our dedicated team is committed to supporting children in reaching their full potential while offering guidance to their families. Our goal is to cultivate a nurturing and inclusive environment where every child receives the highest quality of care. Join us in making a difference in the lives of these special children and their loved ones.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

All duties and responsibilities are to be performed in accordance with CSI’s/Spark policies, procedures, guidelines, contractual commitments, and regulations.
• Contact insurance companies and utilize online portals to verify patient insurance coverage and benefits prior to appointment or procedure
• Enter patient insurance information into the billing system ensuring all data is correct and up to date
• Manually enter CPT charges for medical procedures and diagnosis using ICD-10
• Prepare and submit claims to insurance companies for reimbursement.
• Communicate with healthcare providers and administrative staff to ensure accurate patient data is captured and all necessary documentation is provided for billing
• Stay informed about insurance policies, billing regulations and compliance laws including HIPAA, to ensure billing practices meet legal and regulatory standards.
• Track and monitor expiring authorizations to prevent service interruptions for Participants.
• Collaborate cross-departmentally to ensure timely processing and participant activation.
• Performs other related duties as needed and assigned.

SKILLS AND QUALIFICATIONS:
• High school diploma or equivalent required.
• Minimum of 1-2 years of experience with billing specifically eligibility and charge entry
• Strong organizational and problem-solving skills, including the ability to analyze information, pay attention to detail, take initiative to follow-up on transactions, and make decisions about information.
• Must possess solid skills with email, Internet, and Microsoft Office, including the use of word processing, spreadsheets, and file maintenance programs.
• Must be a self-starter and extremely independent.
• The ability to prioritize tasks and meet deadlines with minimal oversight is required.
• Understanding of insurance policies, eligibility requirements, and billing codes
• Experience using Soneto or Point Click is a plus
• Prescribed Pediatric Extended Care terminology a plus
• Efficiently manage and prioritize multiple tasks to ensure timely completion and high-quality results
• Excellent customer service skills
• Ability to work with others in a courteous, friendly, compassionate and professional manner
• Diligent with attention to detail
• Must be able to multitask and thrive in a fast-paced environment
• Demonstrates awareness of OSHA regulations, Compliance and HIPAA
• Strong organizational skills
• Must be a team player with a positive attitude

POSITION SUMMARY: Spark Pediatrics is excited to announce an opening for a Billing Clerk in our Miami Lakes, Florida headquarters. We are seeking a detailed and proactive Medical Billing Clerk to become a part of our team! In this role, you will be responsible primarily focus on data entry within the billing system, checking patient’s eligibility, and validating authorizations. The ideal candidate will possess excellent communication skills, a strong attention to detail, and an understanding of healthcare billing processes.

BENEFITS:
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

PHYSICAL REQUIREMENTS:

Prolonged periods of sitting at a desk and working on a computer. Ability to perform the essential job functions consistently, safely, and successfully with the ADA, FMLA and other federal, state, and local standards, including meeting qualitative and/or quantitative productivity standards.

Must be able to lift and carry up to 10 lbs; Ability to stand for prolong periods of time and climb steps regularly. Ability to physically maneuver through work areas; bend, lift, carry, reach/extend arms, and hands above shoulder height frequently, or otherwise move in a constantly changing environment.

EOE Statement:
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
EEO/ADA/DFWP

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