Statement of Purpose: This position is accountable for all steps in the billing process including processing medical claim information through data-entry in the EMR, and researching and correcting data entry errors using eClinicalWorks. This position uses knowledge of CPT and ICD-10 codes to determine the appropriate order and combination of alpha, numeric or symbolic data to ensure accuracy in entering medical claim information. This position is in a primary care and behavioral health social service setting with specialized LGBTQ+ care and services. One (1) position available. This is an in office position, that can be based in either, Hillsborough, Pasco, or Pinellas county.

Primary Tasks/Responsibilities

• Translating medical procedures into codes that can be translated by payers, other medical coders, and other medical facilities
• Review claims data to ensure that assigned codes meet required legal and insurance rules, and that required signatures and authorizations are in place prior to submission
• Reviewing and appealing denied and unpaid claims
• Monitoring and updating patient AR balances
• Scrubbing of claims – approx. 200 claims per day.
• Tracking and updating the Aging Report and working patient accounts for accuracy.
• Manage the program for high-quality, timely coding of diagnoses and procedures for medical outpatient and Behavioral Health accounts, using ICD-10, CPT-4, and HCPCS coding classification systems, to meet billing system requirements
• Work closely with physicians, technicians, insurance companies, and other integral parties to uncover and discuss coding analysis results
• Retrieve and collect physician background info from various resources for reporting
• Analyze medical workman comp claims by identifying issues, events, diagnoses, and procedures that resulted in the action
• Prepare summaries and assign the appropriate codes that apply
• Review claims to formulate a synopsis of facts and collaborate with claims examiners regarding the synopsis as needed
• Make corrections to draft reports sent for physician review and submit approved reports to management in a timely fashion
• Interact with claims staff, attorneys, and physicians regarding reports on an as-needed basis
• Working patient collections to reduce AR as assigned
• Assisting with Front Office coverage as needed on a limited basis.
• Other duties as assigned or needed
  
  

Education/Professional

• Minimum of 2 years of experience as a certified coder in primary care and behavioral health setting highly preferred.
• Certification as a CPC for medical practices – (HCPCS, CPT, ICD-10) Required.
• Proven experience in administrative medical information management and computer application
• Ability to work on software applications systems and a willingness to learn
  
  

Knowledge, Skills And Competencies Required

• Knowledge of EMR systems, preferably with eClinicalWorks.
• Microsoft suite and data systems proficiency, including Electronic Medical Records.
• Ability to effectively communicate both written and verbally.
• Ability to effectively utilize problem-solving and decision-making techniques.
• Ability to make effective judgments and decisions based on objective criteria.
• Attentive to detail and strong organizational skills.
• Ability to tactfully interact with diverse personalities.
• High comfort working in a busy environment with changing priorities.
  
  

Requirements

• Must possess and maintain valid Florida driver’s license and proof of insurance
• Must have reliable and accessible auto vehicles.
• Must pass necessary fingerprinting, Level II background checks and employment eligibility verification through the U. S. Department of Homeland Security’s E-Verify system, https://e-verify.uscis.gov/emp.