Responsible for obtaining appropriate reimbursement for accounts receivable across multiple care settings, including physician offices, outpatient and inpatient hospitals, ambulatory surgery centers, urgent care, emergency room, off-site hospitals, and telehealth locations. This role supports timely claims submission, insurance verification, benefits determination, coding review, billing, denial resolution, appeals, and correspondence with payors, patients, and internal departments.
Key duties include reviewing charges and codes for compliance, entering and billing professional charges in the automated billing system, resolving outstanding balances, interpreting remits and EOBs, handling front-end rejections, correcting billing and payment posting errors, and documenting all actions in the billing system. The position also coordinates with revenue cycle, cash posting, refunds, managed care, referral, clinic, and CDQ teams to resolve coding and billing issues.
Experience
- 5 years of healthcare experience in medical billing or related experience required
- Proven ability to develop course work presentations required
- Ability to apply adult learning methodology in training classes/presentations required
- Experience with medical systems preferred
Knowledge
- Knowledge of CPT and ICD coding and current medical terminology required
- Familiarity with insurance verification, claims resolution, denials, appeals, and managed care guidelines
Education
- High School Diploma or GED required
- Bachelor's degree in Healthcare, Finance, IT, or Education preferred
Certification
- Certified Professional Coder (CPC) required
- CPC certification must be completed within 18 months of employment
Other
- Ability to work overtime as needed
- Travel up to 10% may be required
Location
Jacksonville, Florida, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
2 months ago