Support accurate, complete, and timely professional billing for anesthesia services across the Hospital Based Provider Group in Palm Beach County.
Identify missed charges, documentation gaps, coding discrepancies, denial trends, and payment variances; coordinate resolution with anesthesia providers, hospital teams, coders, and billing partners; and strengthen revenue capture while maintaining compliant billing practices.
Responsibilities include:
- Reconcile operating room, labor and delivery, endoscopy, and other procedural schedules with anesthesia records and posted professional charges.
- Investigate missing encounters, duplicate charges, canceled cases, and interface exceptions.
- Review anesthesia records for accurate start and stop times, provider handoffs, overlapping services, and other documentation affecting billable time.
- Validate anesthesia procedure and diagnosis coding, base and time units, provider attribution, and applicable modifiers.
- Review documentation supporting medical direction and concurrency, monitored anesthesia care, physical status, and qualifying circumstances.
- Review separately reportable services, including postoperative pain procedures, nerve blocks, invasive monitoring, and obstetric anesthesia.
- Manage charge holds and documentation exception queues and follow up to resolve incomplete or inconsistent records.
- Analyze anesthesia denials, claim rejections, and underpayments; coordinate corrected claims, appeals, and supporting records.
- Compare payments with payer contracts, anesthesia conversion factors, and reimbursement methodologies.
- Partner with hospital departments, provider enrollment, IT, and external billing vendors to resolve data and claim transmission issues.
- Conduct focused audits, maintain corrective action logs, and educate providers and staff on recurring documentation and charge capture issues.
Requirements & Qualifications
Required qualifications:
- High school diploma or equivalent; additional education or training in medical billing, coding, health information management, or a related field.
- Three years of professional revenue cycle, coding, billing, auditing, or revenue integrity experience, including at least one year working directly with anesthesia professional claims.
- Working knowledge of anesthesia coding and reimbursement, CPT, HCPCS, ICD-10-CM, anesthesia time reporting, medical direction documentation, concurrency, and payer-specific modifiers.
- Experience reconciling encounters and charges, researching denials, interpreting remittance information, and reviewing documentation for claim accuracy.
- Proficiency with electronic health records, practice management or billing systems, and Microsoft Excel.
Preferred qualifications:
- Associate or bachelor’s degree in health information management, healthcare administration, finance, or a related field.
- CPC, CCS-P, or CANPC credential.
- Experience supporting a hospital-based anesthesia group across multiple facilities and collaborating with outsourced billing partners.
- Familiarity with Medicare, Florida Medicaid, and commercial payer requirements affecting anesthesia professional services.
Knowledge and skills:
- Strong analytical skills and attention to detail.
- Clear, professional communication with physicians, anesthesia clinicians, hospital personnel, and billing teams.
- Ability to prioritize work queues, meet deadlines, document actions, and handle protected health information confidentially.
Location
Florida, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago