MEDICAL BILLING AND CODING SPECIALIST (Remote after onsite training)

***THIS ROLE REQUIRES CPC CERTIFICATION AND PERMANENT LOCAL (PINELLAS, HILLSBOROUGH, or PASCO COUNTY, FL) RESIDENCY***

Goes remote within Hillsborough, Pasco, or Pinellas counties after thirty (30) days onsite training in St. Petersburg, FL

JOB SUMMARY

The Medical Billing and Coding Specialist possesses a valid medical coding certification (CPC or similar) and has solid experience in accurately coding orthopedic spine related patient services into billing software to submit accurate insurance claims.  This position is subject to PTO Blackout during the last week of each December due to year end billing process.

ESSENTIAL RESPONSIBILITIES:

• Accurately translates patient information into alphanumeric medical code.
• Submits paper claims with medical records and supporting documentation to insurance carriers, thoroughly including notes in patient accounts.
• Always maintains strict confidentiality and adherence to HIPAA.
• Effectively codes patient services, enters appropriate CPT codes, and gathers modifiers from supporting documentation.
• Accurately organizes and files paperwork, capturing all procedures and visits related to patient history.
• Analyzes information on patient treatment, diagnosis, and procedures to ensure proper coding guidelines are met.
• Demonstrates working knowledge of multiple coding systems, including ICD-10, Level 1 HCPCS, and Level 2 HCPCS.
• Follows up on claim status to confirm whether accepted or denied at clearing house level.
• Researches and corrects all rejections at the clearing house level.
• Acknowledges that PTO/vacation/other voluntary leave is restricted the last week of December due to the fiscal year-end “closing of the books” process.
• Performs other duties as directed or assigned.

QUALIFICATIONS:

• High School Diploma
• Certified Professional Coder (CPC or CPC-A) is required
• Advanced knowledge of medical terminology, billing processes, and matching insurance documentation to support the coding process
• Ability to effectively understand, follow, and communicate oral and written instructions in English.  Must read, write, and speak English fluently to ensure clear work-related communication and patient safety.
• Minimum 3 years medical coding experience – orthopedic spine knowledge required
• Exceptional analytical and problem-solving skills
• Complete understanding of and working experience using various medical billing software and systems
• Able to attend onsite training in St. Petersburg, FL until goals are met for working independently
• Possesses and maintains adequate internet connection and speed to support working remotely post-training
• Must permanently reside in Hillsborough, Pasco, or Pinellas county, Florida

INCLUSIVE, EQUAL OPPORTUNITY EMPLOYER