Medical Billing Specialist

Medical Billing Specialist

Florida Pediatric Associates is seeking an experienced Medical Billing Specialist to join the team.

Hybrid work: Employee will be able to work 4 days from home and 1 from the office.

Top benefits package includes:

• Hybrid work: Employee will be able to work 4 days from home and 1 from the office.
• 90% Employer Paid Employee Medical
• Dental
• Vision
• 100% Employer Paid STD & LTD
• Supplemental Insurance Options
• 7 Paid Holidays
• 401k Plan and Amazing Work Environment

Qualifications:

Education:

• High School Diploma or GED
• Certification in medical coding (CPC) preferred
• Working knowledge of Medicare and Florida Medicaid coding rules and regulations including but not limited to as National Correct Coding Initiative edits and payer guidelines.
• Working knowledge of the current International Classification of Diseases (ICD) Current Procedural Technology (CPT) and Healthcare Common Procedure Coding System (HCPCS) coding and terminology.

Experience:

• Two of more years of medical coding and/or healthcare billing experience.
• ICD CPT and HCPCS coding experience

Principal Duties and Responsibilities:
Specific:

1. Review Client charge submission for accuracy and inconsistency.
2. Review practitioner documentation to verify that ICD and CPT codes are accurate and compatible.
3. Review ICD diagnosis with CPT codes to ensure compatibility.
4. Review CPT code with Site of Service to ensure compatibility.
5. Reconcile Client practice charges to Client appointment schedule rounding list charge capture system and other sources to ensure all patient charges are captured.
6. Verify patient eligibility when needed.
7. Enter patient demographic information when needed.
8. Access facility and Client practice patient health records to obtain current demographic information when needed.
9. Communicate directly with Client practice staff regarding questions pertaining to missing or incorrect information on the encounter form.
10. Review and correct front end claim rejections due to demographic or charge posting errors.
11. Accurately post manual and/or electronic charges into the Practice Management Billing System in a timely fashion to meet or exceed Department performance standards.
12. Understand the proper use of modifiers and assign appropriate modifier where indicated.
13. Review and correct front end claim rejections due to demographic or charge posting errors.
14. Correct claim edits (e.g. NCCI edits coding edits) when indicated.
15. Work with physician charge capture applications when indicated.
16. Promptly report matters that delay or disrupt workflow to the Department Director or designee.
17. Cross-train with billing team members to provide coverage during periods of short staffing including coverage for PTO.
18. Perform other duties as assigned.

General:

• Serve as brand representative for FPA by embracing the Company culture and mission statement core values and standards of conduct.
• Strictly adhere to all Standards.
• Compliance Standards.
• Privacy and Security Standards.
• Workplace Standards.
• Workforce Standards.
• Strictly adhere to Department policies and procedures.
• Participate in quality assurance and quality improvement process.
• Participate in corporate compliance program.
• Promptly report suspected acts of non-compliance with Company Standards and Policies.
• Participate in job-related continuing education programs.
• Perform other duties as assigned by your supervisor or designee.

EEOC Disclaimer:
FPA provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race color religion sex national origin age disability status genetics protected veteran status sexual orientation gender identity or addition to federal law requirements FPA complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment including recruiting hiring placement promotion termination layoff recall transfer leaves of absence compensation and training.

Required Experience:

IC