Billing and Coding Specialist
Location: Tampa, Florida US
Job Number: 1207
Position Title: Lab Billing and Coding Specialist
***This position can be based out of our Laboratory locations in Tampa, FL, Raleigh, NC, or Dallas, TX or Remote within FL, NC, or TX***
Our Laboratory is seeking a Billing and Coding Specialist who will be entrusted with the job of reviewing, auditing, and coding provider’s documentation for the purpose of reimbursement, training, education, and compliance using ICD-10 and CPT codes. The successful applicant will serve as an information resource and guide to our providers, clinical staff, practice managers, members of the Revenue Cycle and Client Services teams and other leadership. This position will be directly involved in analyzing laboratory pre-bill claim edits, claim denials and accounts receivable (AR) management, and working alongside the Revenue Cycle Specialists, will review and amend laboratory denied claims to ensure accurate coding and adherence to payor policy requirements. The Billing and Coding Specialist will perform proactive audits of medical charts and records for compliance with federal coding regulations and guidelines.
Duties and responsibilities:
- Provide review of laboratory billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to coding and billing guidelines
- Complete AR follow up processes, including claim corrections, appeals, payor follow up and resubmissions to expedite reimbursement related to coding or other payor-based denials
- Research, analyze, and respond to inquiries regarding compliance, payor policies and guidelines, coding, denials, and billable services
- Audit medical record documentation to identify coding discrepancies; prepare reports of findings and meet with providers to provide education and training on accurate coding practices and compliance issues
- Obtain clarification of conflicting, ambiguous, or non-specific documentation through provider queries
- Interact with internal and external Revenue Specialists and practice billing teams to ensure appropriate and complete follow-up of patient accounts
- Analyze individual payor performances regarding fee schedule reimbursements and trends
- Monitor and distribute communications regarding payor policy changes and updates, in relation to our provider specialties
- Review, develop, modify, and adapt relevant client procedures, protocols, and data management systems to ensure compliance with organization’s policies
- Illustrate excellent knowledge of healthcare industry regarding the revenue cycle, coding, claims, and state insurance laws, serving as an information source, subject matter expert and guide to clinicians
- Ensure strict confidentiality of financial and medical records
- Perform miscellaneous job-related duties as assigned to impact revenue or drive efficiencies
- Advanced knowledge of medical coding, billing systems, auditing concepts and regulatory requirements
- Ability to use independent judgment and to manage and impart confidential information
- Ability to analyze and solve problems
- Strong communication, presentation, and interpersonal skills
- Knowledge of legal, regulatory, and policy compliance issues related to medical/laboratory coding and billing procedures and documentation
- Knowledge of current and developing issues and trends in medical coding procedures requirements
- Ability to clearly communicate medical information to professional practitioners and/or the public
- Ability to provide guidance and training to professional and technical staff in area of expertise
- Minimum of 3 years’ experience as a biller, coder, or other equivalent administrative medical industry experience
- Laboratory or OB/GYN experience preferred
- Certified Professional Coder (CPC) preferred
- Associates degree from an accredited university preferred
- Athena experience preferred, but not required
- Experience with Salesforce is a plus
Community / Marketing Title: Billing and Coding Specialist
Unified Women’s Healthcare is a company dedicated to caring for Ob-Gyn providers who care for others, be they physicians or their support staff. A team of like-minded professionals with significant business and healthcare experience, we operate with a singular mindset - great care needs great care. We take great pride in not just speaking about this, but executing on it.
As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network. We are advocates for our Ob-Gyn medical affiliates – enabling them to focus solely on the practice of medicine while we focus on the business of medicine.
We are action oriented. We strategize, implement and execute – on behalf of the practices we serve.
Remote Opportunity: 1
EEO Employer Verbiage:
We offer a competitive salary and an excellent benefit package that includes health/dental/life/STD/LTD/vision insurance, paid time off, and 401(k) plan. This company is a drug-free workplace and an Equal Employment Opportunity employer.