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Billing Specialist Job in Naples, Florida

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Job Title: Billing Specialist

Employer:Richichi Family Health
Skills:Coding and billing
Specialties:Primary care
Preferred Certifications:CPC
Required Experience:1 to 2 years
Preferred Experience:1 to 2 years
Location:1217 Piper Blvd Ste 101 Naples 34110-143, FL, US
Date Posted:5/30/2019

Summary of Duties:        This position is an integral part of the central billing function of the Practice; Responsible for collecting, posting and managing account payments; Responsible for submitting clean claims and following up with insurance companies; Evaluates medical record documentation and charge ticket coding to optimize reimbursement and minimize claim denial; Reports directly to the Physician or Billing Supervisor (if applicable).


Essential Responsibilities:

·         Prepares and submits clean claims to various insurance companies electronically (or by paper).

·         Evaluates medical record documentation and charge ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the patient visit, and to ensure that data comply with legal standards and guidelines.

·         Interprets medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct CPT-4 and ICD-9 codes.

·         Reviews Medicare reimbursement claims (and all other insurance claims) before submission for completeness and accuracy and to minimize claim denial.

·         Prepares, reviews, and sends patient statements.

·         Accurate data entry of patient demographic information, charge entry, and posting receipts, adjustments and reserves in accordance with EOBs and patient checks.

·         Reviews and processes insurance payments verifying that insurance companies are paying according to their fee schedules.

·         Performs banking activity by balancing cash drawer, preparing daily bank deposits, securing monies collected.

·         Performs various collection actions, including contacting patients by phone, until there is no balance.

·         Investigates and follows up of all outstanding accounts including collections and denials.

·         Prepares information for the collection agency.

·         Evaluates patient’s financial status and establishes budget payment plans. Follow up and reports status of delinquent accounts.

·         Resolves problems with NSF, bankruptcy, and returned mail.

·         Has working knowledge of various insurance plans and collects co-pays and deductibles as indicated by third party payors.

·         Understanding of computer system in order to assist patients with billing problems.

·         Ability to interact appropriately with difficult patients in an attempt to resolve any questions regarding charges or payments.

·         Communicates documentation discrepancies, coding definitions and questions to medical staff for clarification.

·         Performs coding and documentation quality monitoring activities.

·         Evaluates records and prepares reports, on such topics as number of denied claims or documentation or coding issues, for review by management.

·         Posts all charges and office visit payments within 24 hours of receipt.

·         Responsible for professional atmosphere to include appropriate attire and neat, well organized working area.


Other Job Responsibilities:

·         Ability to assist in other job duties related to front office.

·         Performs daily backups on office computer system.

·         Participates in educational activities and attends routine staff meetings.

·         Conducts self in accordance with RFH’s Employee Manual.

·         Establishes and maintains a professional working relationship with all staff and physicians.

·         Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.

·         Accepts other duties as assigned.



1.       High School Diploma or GED.

2.       Possession of an Accredited Record Technician’s certification (ART) or Certified Coding Specialist designation (CCS) issued by the American Health Information management Association; or two (2) years of experience in medical record billing and coding.




1.       Knowledge of medical billing, coding and collection practices.

2.       Knowledge of computer programs, Medware (or equivalent).

3.       Knowledge of Common Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) and Health Care Procedural Coding System (HCPCS) coding guidelines

4.       Knowledge of medical terminology; anatomy and physiology

5.       Knowledge of Medicare reimbursement guidelines; and third-party operating procedures and practices including comprehension of explanation of benefits (EOBs).

6.       Knowledge of business office procedures.

7.       Ability to operate a computer and basic office equipment; multi-line telephone system.

8.       Ability to research and analyze data, resolve issues; read and interpret medical procedures and terminology.

9.       Must be multi-tasking, well organized, and detail-oriented.


Jason Richichi, richichihealth@gmail.com, Phone 239-514-2008, Fax 239-495-3199

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