Medical Billing and Coding Specialist

JOB OVERVIEW:

Reporting to the Billing Manager, this employee will be a key member of the billing team for this fast-paced, innovative growth company comprised of multiple chiropractic practice brands. The Medical Billing and Coding Specialist will be held accountable for:

· Handling billing of payer and personal injury claims which may be Commercial, Managed Care, Medicaid or Medicare

· Preparing and submitting patient claims to all health insurance payors and personal injury attorneys

· Assisting the billing team with claim submissions, denials and rejections management, patient accounts and various other administrative duties

· Ensuring appropriate codes are assigned and medical documentation is complete

RESPONSIBILITIES:

· Billing:

· Obtain and follow-up on prior authorizations

· Review and confirm that appropriate billing documentation has been obtained, including authorizations and Certificates of Medical Necessity as required

· Post charges and reconcile EOBs for posting payments

· Ensure clean claims submission

· Work with insurance aging reports, denials/rejections, and re-submission of claims taking into consideration coordination of benefits, medical necessity, prior authorization & referral requirements, modifier usage, payor policies, CPT/HCPCS coding, ICD 10 coding and eligibility

· Reconcile open accounts to clearly establish patient responsibility

· Respond to patient phone calls and cases to address billing questions involving coverage such as deductibles, copays, coinsurance, coordination of benefits, eligibility, etc.

· Manage medical records and other document requests from attorneys

· Coding:

· Assign appropriate medical codes to diagnoses and procedures. Ensure compliance with coding guidelines and regulations

· Review patient medical records for accuracy and completeness. Work closely with providers to clarify documentation

· Assist in resolving any coding-related denials or discrepancies

Characteristics and Behaviors for Success:

· A results-oriented style that focuses collaboration with matrix teams to achieve results.

· Ability to master complex business problems and have the intellect and pragmatism to be able to effectively handle ambiguity and manage change. Ability to adapt and be flexible in a rapid changing work environment is required

· Strong attention to detail and accuracy in data entry and documentation

Qualifications:

· 5 years of experience with billing and coding in a physician office setting

· Strong knowledge of CPT, HCPCS, ICD 10 guidelines, Medicare and commercial insurance policies, and claim denial reasons

· AAPC billing and/or coding certification preferred

· Experience with personal injury claims a plus

· Have overall proficiency with revenue cycle workflows

· Must be willing to travel to CHP’s affiliated practice locations should the need arise

Job Type: Full-time

Pay: $24.00 - $30.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: Hybrid remote in Tampa, FL 33606

Salary : $24 - $30