Physician Coding and Billing Lead

3 weeks ago


Tampa, Florida, United States Sherloq Solutions Full time

We are seeking an experienced Coding and Compliance Specialist to lead our physician coding, billing, and follow-up team.

The ideal candidate will have extensive knowledge of CPT-4 and ICD-10 coding, as well as a strong understanding of the professional medical billing, denials and appeals processes.

This position requires strong organizational, problem-solving, and communication skills, as well as the ability to multitask and work effectively in a team environment.

The Coding and Compliance Specialist will be responsible for assisting in training staff and ensuring compliance with insurance guidelines.

The ideal candidate will have experience with Michigan physician claims, insurance reimbursement and coding policies in the EPIC PB Resolute billing system.

Key Responsibilities:

  • Lead a small team including assistance in completing performance reviews, coordinating employee disciplinary actions with management, monitoring employee adherence to company policies, creating training documents and reviewing time card related items.
  • Daily respond to inquiries from the team regarding claim denials, escalated coding issues, insurance payer issues, and workflow.
  • Resolve physician claims through post-bill coding error resolution, billing, appeals, reviewing medical records, EOBs and applying payer reimbursement and coding policies.
  • Present trends and concerns in an understandable way to the team and management with actionable steps for resolution.

Requirements:

  • CPC, RHIA, RHIT, or CCS minimum certification required
  • One (1) year of current verifiable coding experience in ICD-10 and CPT-4 required
  • One (1) year of current verifiable physician coding and abstracting experience required
  • One (1) year of verifiable EPIC PB Resolute billing system required
  • Three (3) years of healthcare industry experience preferred, with a solid understanding of the entire Revenue Cycle process.

We are proud to be an EOE/AA Employer - (Minority/Female/Disabled/Veteran) -We maintain a drug-free workplace and perform pre-employment substance abuse testing.



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