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Principal Specialist, Medical Billing/Coding Expert

Codemax LLC

CodeMax Medical Billing is a specialized revenue cycle management firm serving substance abuse and behavioral health providers nationwide. The organization focuses on maximizing reimbursement while maintaining compliance, accuracy, collaboration, and continuous improvement.

This role is a billing subject matter expert position responsible for guiding the team on medical billing codes, claims processes, and payer requirements. It is an individual-contributor role with no staff management duties, but it plays a critical part in billing accuracy, compliance, and reimbursement performance.

The position supports complex claims, denials, payer disputes, policy interpretation, internal process improvement, quality review, and informal training for billing and coding staff. Behavioral health and substance use disorder billing experience is preferred, but strong general medical billing and payer-rule expertise is the core requirement.

Requirements & Qualifications

Required

  • Deep hands-on expertise in medical billing processes, codes, and payer requirements.
  • Strong working knowledge of ICD-10, CPT, and HCPCS coding.
  • Demonstrated proficiency with Medicare billing rules, CMS guidelines, Medicaid billing requirements, and TRICARE claims requirements.
  • Familiarity with commercial, in-network, out-of-network, and government payer claim requirements.
  • Proven ability to research and interpret complex payer policy and translate it into actionable guidance.
  • Active coding or billing certification such as CPC, CPB, CPMA, CCS, or equivalent demonstrated expertise.
  • Proficiency with healthcare billing software and EHR systems; KIPU and CollaborateMD experience is a plus.
  • Strong analytical, investigative, and problem-solving skills with high attention to detail.
  • Excellent written and verbal communication skills.
  • Must be able to work onsite in Fort Lauderdale, FL; remote work may be considered for highly qualified candidates outside the local area.

Preferred

  • Experience with substance abuse, behavioral health, or mental health revenue cycle management billing.
  • Experience with MAT billing, including methadone and buprenorphine programs.
  • Familiarity with Medicaid managed care plans for behavioral health in Florida or other states.
  • Experience working with substance abuse treatment centers, detox facilities, or outpatient programs.

Education

  • High school diploma or equivalent required.
  • Associate's or bachelor's degree in Health Information Management, Business, or a related field preferred.
  • AAPC or AHIMA certification required.
Benefits & Perks
  • Medical, dental, and vision insurance
  • PTO and paid holidays
  • 401(k) with company match
  • Support for continuing education and professional certifications

Location

Florida, US

Employment Type

Full-time

Experience Level

Senior

Salary Range

$65,000 - $95,000

Remote work allowed

Yes

Posted

1 month ago

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