About Position

Perform a variety of clerical tasks and/or supervisory clerical duties in support of the Occupational Health and Wellness Clinic. Duties include medical coding, medical billing, insurance claims maintenance, related reporting, front desk coverage, and scheduling.

Duties & Responsibilities

Note: Depending on assigned responsibilities, employees may perform some or all of the duties below.

  • Review billing documentation for outpatient and ancillary services rendered by physician(s) and/or support staff by applying the appropriate codes (e.g., Current Procedural Technology (CPT)/ Healthcare Common Procedure Coding System (HCPCS), International Classification of Disease-10 (ICD-10)) from physician documentation, procedure reports, and/or patient records and respective coding rules (e.g., modifiers, diagnosis/procedure relationship, National Correct Coding Initiative (CCI), non-physician provider requirements).
  • Use the electronic medical records (EMR) software, including paper claim processing and paper claim processing programs, to review, prepare, and transmit claims to the appropriate party and monitor the invoice and claims process.
  • Adhere to designated timeframes of processing charge documentation based on initial receipt date while ensuring the highest level of accuracy and coding specificity at all times.
  • Review, coordinate, and update all payer and client billing methodologies to ensure accurate, timely, and compliant billing processes.
  • Provide medical coding training to physician(s) and/or support staff.
  • Work with physician(s) and/or support staff to resolve coding issues and leverage opportunities for improvement and increased cost savings.
  • Code services of questionable or new items and review proper coding with applicable parties.
  • Validate and update any fee forecasting information and trends.
  • Investigate and appeal, if necessary, denied claims.
  • Implement and monitor all aspects of billing and reimbursement corrections, modifications, and additions.
  • Stay up-to-date with changes in reimbursement regulations and Medicare, Medicaid, Florida Workers’ Compensation, and Managed Care coding and billing guidelines, and adapt to changes in coding usage and billing software.
  • Comply with all rules, regulations, and procedures including, but not limited to, Office of the Inspector General (OIG) program, Health Insurance Portability and Accountability Act (HIPAA), Occupational Safety and Health Administration (OSHA), Clinical Laboratory Improvement Amendments (CLIA), and any other state, local, or federally mandated regulations that affect a physician’s office.
  • Create required reports (e.g., financial, health and wellness) within the given timeframe (e.g., as needed, monthly, quarterly), for the applicable parties (e.g., Financial Services Division (FSD), management, agencies).
  • Verify and process vendor invoices; verify documents (e.g., paper and electronic) and other materials for accuracy and completeness.
  • Assist with front desk coverage, answer telephones, register, and schedule patients.
  • May supervise lower clerical staff.
  • Perform other related duties as required.

Knowledge, Skills & Abilities

  • Considerable knowledge of general office policies, procedures, and practices.
  • Considerable knowledge of English grammar, punctuation, and spelling.
  • Working knowledge of CPT/HCPCS and ICD-10 codes.
  • Working knowledge of healthcare and medical terminology.
  • Knowledge of federal, state, and local laws and regulations including the OIG program, HIPAA, OSHA, CLIA, medical coding, and medical billing requirements.
  • Ability to proof own work and the work of other personnel.
  • Ability to perform accurate computations and verification of data.
  • Ability to communicate effectively, both orally and in writing.
  • Ability to be attentive to detail.
  • Ability to read and analyze patient records.
  • Ability to collect, organize, and evaluate data and to develop logical conclusions and/or solutions.
  • Ability to handle confidential information.
  • Ability to operate data processing, word processing, and other office equipment.
  • Ability to document information in an EMR.
  • Ability to work effectively with others.
  • Ability to type.

Required Minimum Education & Experience

  • A high school diploma or possession of a GED certificate.
  • Three years of medical billing and coding experience.
OR
  • A high school diploma or possession of a GED certificate.
  • Successful completion of a medical or business professional training program.
  • Two years of medical billing and coding experience.
OR
  • An associate's degree from an accredited institution of higher education.
  • Two years of medical billing and coding experience.

Required Pre-Employment Testing

  • A passing score on pre-employment testing.
  • 30 net words per minute on a typing test; or 100 gross keystrokes per minute with 90% accuracy on a data entry test.

Preferred Education & Experience

  • Associate’s degree or higher from an accredited institution of higher education preferably in business.
  • Five years of medical billing and coding experience.
  • Experience with eClinicalWorks.
  • Experience with Microsoft Office Excel and Word.
  • A valid medical coder or medical biller certification (e.g., Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Medical Coder (CMC), Certified Professional Biller (CPB), Certified Billing and Coding Specialist (CBCS)) from a certifying entity (e.g., American Academy of Professional Coders (AAPC), American Health Information Management Association (AHIMA), Practice Management Institute (PMI), National Healthcareer Association (NHA)).

Additional Job Requirements

  • Depending on assignment, employees may be required to possess a valid Florida Driver License at time of employment. Driving history will be thoroughly reviewed and may be grounds for disqualification.
  • No visible tattoos on face. Tattoos on hands, neck, or arms must be covered with white, black, or neutral colored covering.
  • No illegal drug sale within lifetime.
  • No illegal drug use within the past 36 months. No marijuana use within the last 24 months.
  • No felony convictions within lifetime.
  • No misdemeanor convictions involving perjury, false statement, or domestic violence within lifetime.
  • No dishonorable discharge from any branch of the United States Armed Forces, the United States Coast Guard, National Guard, or Reserve Forces.
  • Successful completion of a criminal background investigation including polygraph; reference, employment, and neighborhood checks; medical evaluation; and drug screening.

We believe that diversity and inclusion among our applicants and employees is critical to our success as a community partner. We seek to offer employment opportunities without regard to race, color, religion, sex, pregnancy, national origin, age, physical/mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information, and military/veteran status. We proudly recognize veterans' preference and are committed to a drug-free and tobacco-free workplace. Job information is updated daily at noon.