Coding and Billing Specialist

This is a fully remote position, open to applicants in Florida.

📋 Description

• Evaluate documentation related to hospital services to ensure accurate coding of principal diagnoses, secondary conditions, procedures, and social determinant codes.

• Implement coding standards set by the American Hospital Association, Current Procedural Terminology, ICD-10-CM, as well as payer-specific and drug-administration guidelines.

• Review revenue charge capture processes, revenue codes, grouper functionalities, and their financial implications on hospital billing.

• Input and assess charges related to surgical procedures, supplies, implants, pharmacy, contrast agents, and patient-supplied items.

• Assign codes for both concurrent and discharged accounts across various specialties.

• Achieve monthly production and quality benchmarks.

• Examine high-risk encounters for any missing or erroneous charges prior to encounter completion.

• Utilize payer-specific trends and modifier requirements to minimize billing recaptures.

• Manage clinical documentation queries concerning levels of service, chronic conditions, HCCs, and RAFs.

• Extract pertinent data from hospital information systems and external records.

⛳️ Requirements

• An associate's degree is mandatory.

• Knowledge of Medical Terminology, Anatomy, and Physiology is required.

• One of the following certifications is necessary: CPC, CCS, RHIT, RHIA, or COC.

• CRC certification is preferred.

• 3-5 years of relevant experience is required.

• Proficient understanding of ICD-10-CM, CPT-4, modifier applications, and coding guidelines is essential.

• Certification must be maintained.

• Familiarity with hospital information systems and intricate filing schemas is necessary.

• Understanding of payer-specific regulations, revenue codes, grouper functionalities, charge capture, and billing requirements is important.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and continuing education.

• Supportive work environment with a focus on teamwork and collaboration.