Company Description

Borland Groover is one of Florida’s leading gastroenterology providers. Founded in 1947, our mission is to provide exceptional care and improve the lives of our patients. We value ourselves on delivering quality care (quality), doing the right thing (accountability), caring for our patients (compassion), and taking care of our employees (collaboration). If you love the vision of Borland Groover, and find your values aligning with ours, apply to join our team!

Position Summary

The Certified Professional Coder at Borland Groover is a part of the medical billing team and is responsible for accurately applying procedural and diagnosis codes and entering charges into the billing system in a timely fashion.

A Certified Professional Coder (CPC), is a healthcare professional who specializes in medical coding. Medical coding involves the translation of medical diagnoses, procedures, and services into numeric or alphanumeric codes. These codes are used for various purposes, including medical billing, insurance claims processing, healthcare analytics, and research. A Certificated Medical Coder is someone who has obtained certification in medical coding to demonstrate their proficiency and knowledge in this field.

Essential Job Functions

• Medical Terminology – understanding the GI Anatomy
• Answering coding questions from other departments
• Create daily schedules through NextGen
• Request operative and procedural reports when missing
• Pull any needed reports from email, shared drives, chart or, other locations
• Code procedural and operative reports from each center/hospital
• Code evaluation and management services
• Audit all accounts for accurate demographic data entry prior to billing
• Key all charges to the applicable payers
• Work appointment billing analysis to ensure that all outpatient reports have been received and billed
• Work/Audit inpatient lists and unbilled to ensure that all inpatient charges have been received and billed
• Work daily/weekly unbilled tasks
• Communicate with the point of contact for outstanding dictations or reports
• Provide continuous feedback to the physicians regarding their work
• Patient billing
• Educate staff on coding guideline changes.
• This job requires access to Personal Health Information (PHI), HIPAA training is required, and HIPAA compliance is expected.
• Must follow the organization’s Code of Conduct
• Must participate in the Compliance Program Initiatives and reporting and Compliance Issues
• Ability to assist team lead in team lead duties (i.e. – audits, training, specific spreadsheets, projects, etc.)
• Other duties assigned
  
  

General Qualifications

• Medical Coding & Knowledge: Assign appropriate codes to medical diagnoses, procedures, and services using standard coding systems, such as Current Procedural Terminology (CPT), International Classification of Diseases (ICD), and Healthcare Common Procedure Coding System (HCPCS)
• Accuracy: Ensure accuracy and compliance with coding guidelines and regulations to prevent coding errors that could lead to billing discrepancies or compliance issues; attention to detail
• Documentation Review: Review medical records, physician notes, and other clinical documentation to extract relevant information for coding. This may involve interacting with healthcare providers to clarify documentation as needed.
• Billing Support: Collaborate with billing specialists to generate accurate and compliant insurance claims based on the coded information. This includes submitting claims to insurance companies and government healthcare programs.
• Data Quality: Contribute to data quality and integrity by maintaining consistent and accurate coding practices. High-quality data is essential for healthcare analytics and research.
• Compliance: Stay updated with changes in coding guidelines, regulations (such as those from the Centers for Medicare & Medicaid Services - CMS), and industry standards. Ensure that coding practices are compliant with these requirements.
• Continuing Education: Maintain certification through ongoing education and training. Medical coding is a dynamic field, and coders need to stay current with changes in healthcare practices and coding systems.
• Coding Specialization: Some Certificated Medical Coders may specialize in specific areas of healthcare, such as inpatient coding, outpatient coding, professional fee coding, or coding for specific medical specialties (e.g., GI, radiology)
• Communication: Communicate with healthcare providers, billing staff, and insurance companies to resolve coding-related issues, clarify coding choices, and address any coding-related inquiries; ability to work as a team member
• Computer Skills: Proficiency in using computer software and data entry tools is essential. Familiarity with electronic health record (EHR) systems is often required.
• Confidentiality: Understanding and commitment to maintaining patient confidentiality and adhering to healthcare privacy regulations
• Problem Solving: Being able to identify and rectify data entry errors and discrepancies is crucial
• Time management: The ability to work efficiently and manage time effectively, especially in a fast-paced healthcare environment
• Typing Skills: Fast and accurate typing skills are necessary to efficiently input data
  
  

Education And Experience

• High School diploma required
• Previous experience in GI coding/billing is preferred but not necessary
• Completed certification program for coding/billing required (CPC)
  
  

Physical Requirements

• Ability to stand, walk, and sit for an extended period of time.
• Ability to communicate in English.
• Ability to see within normal parameters.
• Ability to hear within normal range.
• Ability to use hands, arms, and legs within the specifications of the job
  
  

Benefits (full-time Only)

• Health Insurance
• Dental Insurance
• Vision Insurance
• 401K Retirement Plan
• Life Insurance
• Short- and Long-term disability
• Profit Sharing
• Supplemental Insurance
• Education and Tuition Reimbursement funding
• Initial Uniform Allowance
• Employee Assistance Program (EAP)
• Paid Time Off (PTO)
• Volunteer Time Off (VTO)
• Paid Holidays
  
  

IMPORTANT NOTE

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be an exhausted list of duties, responsibilities, and skills. Borland Groover is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. We thank all applicants for their interest, however only those selected for an interview will be contacted.