Medical A/R Specialist

TEKsystems•South Miami, FL

6d•$24 - $26•Onsite

About The Position

This is a Contract position based out of South Miami, FL. The pay range for this position is $24.04 - $26.44/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave). This is a fully onsite position in South Miami,FL. This position is anticipated to close on Oct 19, 2026.

Requirements

AA preferred or equivalent.
Managed Care/HMO contract billing experience required.
3-5 years prior experience in Billing of claims.
Understanding of all required fields on a 1500 and/or UB for hospitals and diagnostic facilities is required.
Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus.
Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims a plus.
Knowledge and understanding of: Medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD-9/10, CPT-4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, On-line verifications (DDE) ; Internet savvy ; knowledge of Microsoft Suite a must.
Extensive analytical ; critical thinking ; detail oriented ; problem solver ; good mathematical, writing, and interpersonal skills required.
Must be able to communicate effectively with other depts. in order to resolve pending/missing information on claims to expedite the timely transmission to payers.
Excellent Time-Management skills.
Ability to multi-task and work under pressure in order to meet stringent deadlines.

Nice To Haves

Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus.
Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims a plus.

Responsibilities

Review and resolve missing or inaccurate claim information to ensure timely claim submission.
Manage assigned billing work queues and submit clean, accurate claims.
Resolve claim edits, denials, and outstanding AR balances using available tools and resources.
Review claims and supporting documentation for billing and coding accuracy.
Prepare and submit appeals, track outcomes, and maintain compliance with payer and HIPAA requirements.
Apply payer guidelines and contract terms when addressing reimbursement and denial issues.
Escalate reimbursement, credentialing, contractual, and system issues as appropriate.
Monitor claims to ensure filing deadlines are met and claims are processed timely.
Maintain compliance with all payer, regulatory, and organizational billing requirements.
Provide coverage across billing queues and assist with special projects as needed.