** This is not a remote position**
Under direct supervision of the
Revenue Cycle Manager, this position reviews and resolves coding issues related
to billing; researches coding issues and participates in process improvements
related to coding and AR management. This position may also provide education
to providers and staff on correct documentation, coding, and billing of medical
with accuracy and ensure changes are within the scope of the policies.
that claims are passing internal edits in a timely fashion.
that denied claims, are corrected or appealed in a timely manner.
appropriate feedback to management.
§ High School Diploma or general education degree (GED)
§ CPC, CPC-A, RHIT or CCS Certification required.
§ 2 – 4 years of physician office coding and
denial management experience.
§ Knowledge of ICD10, CPT HCPCS and the use of modifiers
§ Surgical coding experience preferred.
§ Knowledge of Medicare Part B and commercial insurance
products and plans.
§ Familiar with CMS 1500 completion preferred.
§ Advanced understanding of medical terminology and
§ Familiar with NCCI guidelines.
§ Athena experience preferred.
§ Excellent communication skills both written and verbal.
§ Must be detail oriented and a self-starter
§ Requires comprehensive knowledge of computer skills
including Microsoft Office Suite
§ Comfortable in a fast-paced working environment of a
§ Determine that appropriate
information is submitted to insurance companies.
§ Ensure that the actions taken on
denied claims are paid on the first follow-up call or appeal.
§ Maintains up to date knowledge
of billing and reimbursement.
§ Identify and communicate AR
trends and denial issues impacting AR or daily production.
§ Ability to meet productivity and
§ Request appropriate adjustments
based on contract, modifiers or appeal denials.
§ Works to understand the
procedures billed in OP notes or bundling issues to maximize the value of
§ Utilizes the coding resources
(CPT, ICD-10, AAOS books, Decision Health and Select Coder) to understand
§ Corrects accounts that are
billed incorrectly in the PM.
§ Helps the Revenue Cycle
Specialists understand and complete their correction requests.
§ Assure compliance with all
company plans, policies and procedures set forth by the Florida Orthopaedic
§ All other duties as assigned.