Responsibilities
- Review provider documentation and accurately assign ICD-10-CM, CPT, and HCPCS codes in accordance with current coding guidelines, payer requirements, and regulatory standards.
- Review, prepare, and submit clean claims to Medicare, Medicaid, and commercial insurance carriers, ensuring accurate coding, patient information, modifiers, and billing details to support timely reimbursement.
- Research denied, rejected, or underpaid claims; identify root causes; make necessary coding or billing corrections; submit appeals when appropriate; and follow claims through resolution.
- Monitor coding and billing practices for compliance with CMS and payer guidelines, identify documentation or coding deficiencies, and communicate with providers and clinical staff regarding documentation requirements and coding best practices.
- Monitor outstanding insurance accounts, work aging reports, resolve billing discrepancies, and collaborate with internal teams and payers to improve collections, reduce denials, and support an efficient revenue cycle.
Requirements & Qualifications
Qualifications
- AAPC Certified Professional Coder (CPC) and Certified Professional Biller (CPB) required.
- Knowledge of Medicare billing guidelines required.
- Knowledge of commercial payor guidelines preferred.
- Minimum of 2 years of medical billing and coding experience required.
- Applicants should live within reasonable commuting distance of St. Augustine, FL to be available to attend required in-person meetings.
Location
Florida, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
From $80,000
Remote work allowed
Yes
Posted
3 weeks ago