Medical Billing Specialist

POSITION TITLE: REPORTS TO:

Practice Manager

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OCCUPATIONAL SUMMARY
Responsible for coding procedures and entering charges to comply with federal/state regulations and internal policies. Coordinate with Practice Manager and Physicians to assure all necessary documentation is present to support selected procedure codes or to code cases as needed. Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improved coding issues identified.
PRIMARY DUTIES AND RESPONSIBILITIES Responsible for reviewing compliance regulations and coding requirements (primarily Medicare) and incorporates these changes into the coding process.

• Educates Practice Manager and/or Providers on compliance and coding regulations.
• Coordinates with Practice Managers, and Providers on new procedures being performed to assure the charges are set up appropriately and timely and the staff responsible for entering charges is educated.
• Reviews procedure/surgical documentation and provides education surrounding necessary improvements to accurately code encounters.
• Participates in audits to assure all documented charges are being captured and performs audits to confirm that charges are being billed correctly on the claim.
• Works to resolve any coding denial issues. Works work site driver to ensure that denials are being resolved daily for any coding related issues.
• Performs insurance verification and authorization for procedures/surgeries within the practice setting.
• Enters coded visits within the practice management system and ensures accuracy of claim prior to submission.
• Responsible for collection physician billing information for submission. Develops a methodology for practice to ensure that procedures and surgeries are captured and reconciled for assigned practice.

PROFESSIONAL DEVELOPMENT

• Actively participates in applicable educational opportunities.
• Demonstrates willingness to improved services by problem solving and offering suggestions.
• Contributes to the morale of the department by participation, attitude, teamwork and professionalism.

PRACTICE CODING SPECIALIST PAGE2

ADDITIONAL DUTIES AND RESPONSIBILITIES

• Other duties as assigned by supervisor.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not construed to be an exhaustive list of all job duties performed by the personnel so classified.

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION REQUIRED

1. Must have a verified coding credential through the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Must have minimum of 2 years hospital and/or physician practice coding experience or successful completion of the one-year Revenue Integrity Internship Program.

• Demonstrated communication skills and an ability to work independently and deal effectively with various types of personnel.
• Knowledge of Microsoft Office products.

SERVICE EXCELLENCE BEHAVIORAL EXPECTATIONS

• Demonstrates professionalism
• Practices respectful and effective communication
• Anticipates and responds promptly to needs and requests of others
• Takes ownership and accountability for actions and behaviors in the workplace
• Demonstrates care and compassion for others
• Demonstrates commitment to co-workers

LICENSE OR CERTIFICATION REQUIRED BY THE STATE OF FLORIDA

Job Type: Full-time

Pay: $17.00 - $20.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• ICD-10: 2 years (Required)

Work Location: One location