Managed Care Billing and Coding Specialist - Fort Myers, United States - SantéPlus Medical Center

Description

Responsibilities:

Review and analyze medical records, ensuring appropriate coding of diagnoses, procedures, and services rendered in accordance with managed care guidelines.

Assign accurate codes (e.g., CPT, ICD-10, HCPCS) to medical services, ensuring compliance with coding standards and regulatory requirements.
Conduct thorough audits of coding and billing processes to identify discrepancies, errors, or potential compliance issues.
Collaborate with healthcare providers and staff to clarify documentation and ensure accurate coding.
Verify insurance coverage, pre-authorization requirements, and billing guidelines for managed care plans.
Generate and submit electronic claims to insurance providers, ensuring accuracy and completeness.
Monitor claim status, follow up on denials or rejections, and facilitate timely resolution of billing issues.
Stay up-to-date with changes in managed care policies, coding guidelines, and reimbursement rates, ensuring compliance with industry standards.
Provide education and training to clinic staff regarding managed care billing and coding updates and best practices.

Collaborate with the billing team to reconcile and resolve billing discrepancies and outstanding accounts receivable related to managed care claims.

Qualifications:

High school diploma or equivalent (Associate's degree or certification in medical coding preferred).
Minimum of two years of experience in managed care billing and coding, preferably in a multi-location medical clinic setting.
Proficient knowledge of medical terminology, anatomy, and physiology.
Strong understanding of CPT, ICD-10, and HCPCS coding principles and guidelines.
Experience with managed care billing software and electronic health record systems.
Familiarity with insurance verification, pre-authorization processes, and managed care contracts.
Solid understanding of HIPAA regulations and compliance related to billing and coding practices.
Excellent attention to detail and accuracy, with strong analytical and problem-solving skills.
Effective communication skills, both written and verbal, with the ability to interact with healthcare providers, staff, and insurance representatives.
Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.


Pay:
$ $26.00 per hour


Benefits:

• 401(k)
• 401(k)

matching

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Medical office

Experience:

• ICD10: 3 years (required)

Work Location:
In person