Job Summary
The Billing Specialist is responsible for the accuracy of the superbill/claim prior to transmission to the payer, including validation of appropriate CPT, HCPCS, and ICD-10-CM codes.
Duties
- Assign and remove CPT, HCPCS, and modifiers as part of the superbill/claim validation process.
- Prepare and review superbills/claims prior to submission.
- Identify coding trends and opportunities to improve quality, efficiency, and productivity.
- Check each insurance payment for accuracy.
- Ensure compliance with billing and payer guidelines.
- Contact insurance companies regarding payment discrepancies when necessary.
- Research and appeal denied claims.
Requirements & Qualifications
Qualifications
- High school diploma or GED equivalent.
- Minimum of 1 year of experience as a medical biller.
- Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
- Knowledge of CPT, ICD-10-CM, and HCPCS codes.
- Knowledge of coding principles and guidelines.
- Knowledge of billing principles and guidelines.
- Knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for professional and technical services.
- Excellent written and oral communication skills.
- AAPC CPC or AHIMA CCS certification preferred but not required.
Location
Florida, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago