Under direct supervision of the Revenue Cycle Manager, this position reviews and resolves coding issues related to billing, researches coding issues, and participates in process improvements related to coding and AR management. It may also provide education to providers and staff on correct documentation, coding, and billing of medical claims.
Responsibilities include:
- Work with accuracy and ensure changes are within the scope of the policies.
- Check that claims are passing internal edits in a timely fashion.
- Ensure denied claims are corrected or appealed in a timely manner.
- Provide appropriate feedback to management.
- Determine that appropriate information is submitted to insurance companies.
- Ensure that actions taken on denied claims are paid on the first follow-up call or appeal.
- Maintain up-to-date knowledge of billing and reimbursement.
- Identify and communicate AR trends and denial issues impacting AR or daily production.
- Meet productivity and accuracy standards.
- Request appropriate adjustments based on contract, modifiers, or appeal denials.
- Work to understand procedures billed in OP notes or bundling issues to maximize the value of submitted appeals.
- Utilize coding resources to understand denied procedures.
- Correct accounts that are billed incorrectly in the PM system.
- Help Revenue Cycle Specialists understand and complete correction requests.
- Ensure compliance with company plans, policies, and procedures.
- Perform other duties as assigned.
Monday through Friday, full-time.
Requirements & Qualifications
Qualifications
- High school diploma or GED required.
- CPC, CPC-A, RHIT, or CCS certification required.
- 2–4 years of experience.
- Knowledge of ICD-10, CPT, HCPCS, and modifiers preferred.
- Surgical coding experience preferred.
- Knowledge of Medicare Part B and commercial insurance products and plans.
- Familiarity with CMS 1500 completion preferred.
- Advanced understanding of medical terminology and anatomy.
- Familiarity with NCCI guidelines.
- Athena experience preferred.
- Excellent written and verbal communication skills.
- Detail oriented and self-starter.
- Strong computer skills, including Microsoft Office Suite.
- Ability to work in a fast-paced environment.
Benefits & Perks
Benefits
- Medical insurance
- Vision insurance
- Dental insurance
- Life insurance
- Disability insurance
- 401(k) / profit sharing
- Competitive compensation
- Drug-free workplace
Location
Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
2 weeks ago