Address
Form of work
SalaryIn this role you will:
Review and resolve coding issues related to billing; research coding issues and participate in process improvements related to Spine coding and AR management. This position may also provide education the organization's Spine Service providers and staff on correct documentation, coding, and billing of medical claims.
- Work with accuracy and ensure changes are withIN THE scope of the policies.
- Check that claims are passing internal edits in a timely fashion.
- Ensure that denied claims, are corrected or appealed in a timely manner.
- Provide appropriate feedback to management.
Key Responsibilities
- Determine that appropriate information is submitted to insurance companies.
- Ensure that the actions taken on denied claims are paid on the first follow-up call or appeal.
- Maintains up to date knowledge of billing and reimbursement.
- Identify and communicate AR trends and denial issues impacting AR or daily production.
- Ability to meet productivity and accuracy standards.
- Request appropriate adjustments based on contract, modifiers or appeal denials.
- Works to understand the procedures billed in OP notes or bundling issues to maximize the value of submitted appeals.
- Utilizes the coding resources (CPT, ICD-10, AAOS books, Decision Health and Select Coder) to understand denied procedures.
- Corrects accounts that are billed incorrectly IN THE PM.
- Helps the Revenue Cycle Specialists understand and complete their correction requests.
- Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute
- All other duties as assigned.
About You:
- High School Diploma or general education degree (GED)
- CPC, CPC-A, RHIT or CCS Certification required.
- 2-4 years of Spine physician office coding and denial management experience.
- Knowledge of Medicare Part B and commercial insurance products and plans.
- Advanced understanding of medical terminology and anatomy.
- Familiar with NCCI guidelines.
- Excellent communication skills both written and verbal.
- Must be detail oriented and a self-starter
- Requires comprehensive knowledge of computer skills including Microsoft Office Suite
- Comfortable in a fast-paced working environment of a growing practice
- Knowledge of ICD10, CPT HCPCS and the use of modifiers
- Spine surgical coding experience
- Familiar with CMS 1500 completion
- Athena experience
At FOI our goal is to provide our patients with world-class orthopedic care.
Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encounter with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations.
What we offer:
- Full time opportunities available, with room for career growth and advancement.
- Excellent job security and stability, to promote an optimal work life balance.
- Be part of this dynamic and growing high level Orthopaedic Spine Coding team!
