Certified Coding Specialist

4 weeks ago


Jacksonville, Florida, United States North Florida Surgeons Full time
Job Title: Certified Coder

North Florida Surgeons is seeking a highly skilled Certified Coder to join our team. As a Certified Coder, you will play a critical role in ensuring accurate and timely claims submission, while maintaining compliance with CPT, government, and carrier policies and guidelines.

Key Responsibilities:
  • Apply advanced coding knowledge to submit claims on behalf of the company for services rendered by providers within the organization as assigned.
  • Serve as the knowledge base for coding assistance to physician and staff, providing training on new and changing coding policies from government and commercial carriers.
  • Maintain claim submission and carrier response within timely filing limits set forth by the carrier and/or carrier contracts.
  • Review accounts for proper reimbursement from carriers and patients, and submit adjustment requests for approval for fully worked claims.
  • May contact insurance companies and patients regarding payment in a timely manner, and may contact insurance companies regarding appeals and reviews of medical claims.
  • Determine appropriate coding on denied claims, send reviews and appeals where necessary, and maintain good working relationships with divisions by providing support and feedback.
  • Participate in compliance training for office, maintain patient confidentiality, and monitor daily and weekly reports to achieve overall coding and claim oversight.
  • Coordinate with the division with respect to bad debt and collection efforts, and continuously educate in areas specific to industry (coding, billing, and insurance contracts).
Requirements:
  • Must reside in the state of Florida.
  • Knowledge of clinic charging, billing, and registration policies and procedures, as well as insurance billing procedures.
  • At least 5 years of accounts management/billing experience in a health care organization, with 5 years minimum of General surgery, ENT, and/or orthopedics coding from office notes and operative reports.
  • Certified Professional Coder (CPC) certification is required.
Environmental/Working Conditions:

Work is performed primarily in a remote environment with office work as scheduled or as needed. Involves frequent telephone contact with patients. Work may be stressful at times, and interaction with others is constant and interruptive.



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