Certified Coder

2 weeks ago


Jacksonville, Florida, United States North Florida Surgeons Full time
Job Summary

We are seeking a highly skilled Certified Coder to join our team at North Florida Surgeons. The successful candidate will be responsible for applying advanced coding knowledge to submit claims on behalf of the company for services rendered by providers within the organization as assigned.

Key Responsibilities
  • Apply accurate coding to submit initial clean claims to ensure prompt and accurate payment, exercising compliance in accordance with CPT, government, and carrier policy and guidelines.
  • Maintain claim submission and carrier response within timely filing limits set forth by the carrier and/or carrier contracts.
  • Maintain current levels of account aging for assigned offices.
  • Maintain productivity and quality standards as set by the company.
  • Reviews accounts for proper reimbursement from carriers and patients.
  • Submits adjustment requests for approval for fully worked claims.
  • May contact insurance companies and patients regarding payment in a timely manner.
  • May contact insurance companies regarding appeals and reviews of medical claims.
  • Determines appropriate coding on denied claims, sends reviews and appeals where necessary.
  • Maintains good working relationship with divisions by providing support and feedback by making recommendations for coding and/or billing to physician and/or office management staff.
  • Contacts divisions as necessary to research coding, insurance, and billing issues.
  • Participates in compliance training for office.
  • Maintains patient confidentiality.
  • Monitors daily and weekly reports to achieve overall coding and claim oversight.
  • Coordinates with the division with respect to bad debt and collection efforts.
  • Continuous education in areas specific to industry (coding, billing, and insurance contracts) by utilizing bulletins, newsletters, seminars, etc.
  • May be responsible for payment posting as needed.
  • Maintains CEU's for continued certification.
  • Performs other duties as required.
Requirements
  • Must reside in the state of Florida.
  • Knowledge, Skills, and Abilities: Knowledge of clinic charging, billing, and registration policies and procedures. Knowledge of insurance billing procedures. Knowledge of clinic departments and operational relationships. Skill in defining problems, collecting data, interpreting billing information. Skill in computer applications. Ability to perform mathematical computations and compute ratios and percentages. Ability to work pleasantly and effectively with patients and co-workers. Ability to communicate clearly.
  • Education: High school diploma, coding and billing courses helpful.
  • Experience: At least 5 years accounts management/billing experience in a healthcare organization. 5 years minimum of General surgery, ENT, and/or orthopedics coding from office notes and operative reports.
  • Certificate/License: Certified Professional Coder, non-CPC or CPC-A need not apply. Must live in Florida.


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