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Medical Billing Specialist - Wound Care

Medical Billing Specialist - Wound Care

Heal PreciselySaint Petersburg, FL, US
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Job Description

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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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    Medical Billing Specialist • Saint Petersburg, FL, US