Medical Coding Specialist - Pensacola - Retina Specialty Institute

Description

Job Title

Medical Coding Specialist

Department: Finance, Revenue Cycle Management

Reports to: RCM Manager

FLSA: Non-Exempt (Hourly)

Job Type: Full-time, 40 hours per week. On-site.

About Us

We are dedicated to preserving and improving the gift of sight at Retina Specialty Institute and Southern Eye Group. As growing leaders in ophthalmology, we utilize cutting-edge technology and advancements in healthcare to provide exceptional care to our patients. Our commitment to excellence prioritizes patient care above all else, ensuring each patient receives the highest standard of treatment.

General Purpose of Job/Summary

We seek a detail-oriented and experienced Ophthalmic Coding Specialist to join our team. This role plays a crucial part in optimizing practice revenue and ensuring timely and accurate billing for patients. The specialist will be responsible for accurately coding and billing optometry and ophthalmology services, ensuring compliance with medical coding regulations and maximizing reimbursement for all provided services.

Essential Duties and Responsibilities

• Review and interpret medical records to accurately assign ICD-10, CPT, and HCPCS codes for procedures and diagnoses.
• Enter coded data and other patient information into practice management software, perform accuracy checks, and submit claims to insurance companies.
• Follow up on unpaid claims within the standard billing cycle timeframe, verifying each insurance payment for accuracy and compliance with contract terms.
• Address and resolve billing and insurance discrepancies, engaging with insurance companies and patients as necessary.
• Stay informed about current coding guidelines and reimbursement reporting requirements, ensuring compliance with all legal standards.
• Conduct audits and coding reviews to verify all documentation is accurate, compliant, and precise.
• Collaborate with physicians, administrators, and other medical staff to ensure billing accuracy.
• Provide patient education regarding billing processes and insurance as needed.
• Prepare and submit regular reports to the billing supervisor or manager.

Qualifications

• High school diploma or equivalent required.
• Proficient in medical terminology, ICD-10, and CPT coding.
• Familiarity with ophthalmology procedures, terminology, and patient care services.
• Preferred: Associate degree or higher; 2 years of experience in medical coding and billing in an ophthalmology or optometry setting.

Required Skills and Abilities

• Outstanding interpersonal skills; handles company business with professionalism, discretion, and tact.
• Will observe all company confidentiality requirements and HIPAA regulations to protect patient privacy and maintain HIPAA compliance.
• Can remain calm and professional in situations of high pressure, stress, and/or emotion.
• Demonstrated proficiency with technology; familiarity with electronic medical records (EMR) systems and electronic billing systems.
• Strong organizational and time management skills with an affinity for detail.
• Excellent verbal and written communication skills.
• Ability to work independently and collaboratively in a team.
• Maintain a composed demeanor, pleasant attitude, and polished, professional appearance.

Benefits

• Competitive salary commensurate with experience.
• Health, dental, and vision insurance.
• Life insurance, disability coverage, and ancillary benefits offered.
• 401k eligibility with company match.
• Paid time off and holidays.
• Opportunities for professional development and certification.
• Friendly, upbeat, and supportive work environment.

Equal Opportunity Employer

Retina Specialty Institute and Southern Eye Group are equal opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. It is the policy of our companies not to discriminate on the basis of age, color, sex, disability, national origin, race, religion, gender identity, sexual orientation, veteran status, or any other characteristic protected by law.

Physical Requirements and Work Environment

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions to the extent the Company may do so without undue burden.

This role involves sitting for extended periods at a desk and working on a computer. Occasional standing, walking, stooping, kneeling, crouching, reaching, and lifting up to 15 pounds may be required. Specific vision abilities needed include close, distance, peripheral vision, and focus adjustment.

The work takes place in a climate-controlled office with moderate noise levels.

Other Duties

This job description provides an overview of key duties but is not all-inclusive. Responsibilities and tasks may evolve over time, and adjustments may be made as needed, with or without prior notice.