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Riverside Recovery of Tampa · 3 days ago

Billing and Coding Specialist

Tampa, FL 33603

Full-time

Onsite

Entry Level

$23/hr - $25/hr

1+ years exp

Riverside Recovery of Tampa is seeking a Billing and Coding Specialist responsible for ensuring accurate billing and coding for clients. The role involves managing claims submission, payment posting, and maintaining the integrity of billing data while communicating with health insurers regarding claims.

Addiction TreatmentHealth CareOutpatient CareRehabilitation

Responsibilities

Manages all claims submission and payment posting

Ensures data is formatted, coded, and submitted in an accurate and compliant manner

Submits claims files to payers and posts payments using Electronic Data Interchange (837p and 835ERA)

Identify and implement coding and submission requirements of individual payers and funding sources

Monitors payer and clearinghouse submission reports and troubleshoots problems

Monitors payer correspondence for updates and information affecting the claims process or reimbursement

Monitor that the insurance electronic claim billing process is completed successfully daily

Ensures claims are submitted within a timely manner

Maintains and ensures the integrity of billing and claims related data

Analyzes claims and billing data to identify trends and examine claim denial issues

Communicate with health insurers regarding pending and any unpaid claims

AR follow-up and denials. Research denials, submit appeals and ensure payments are received on all outstanding claims

Follow up with 3rd party organizations after careful review of claims with Overpayment/Recoup Requests

Post all insurance payments to the patient’s accounts in CMD

VA accounts will be the responsibility of the manager, billing and coding specialist will assist as needed upon request

Maintains line of communication and serves as the primary contact for all claims and billing matters payer assigned

Understands claims data elements and structure in detail pertaining to Substance Abuse & Mental Health services and appropriate diagnoses assigned

Ensures that client accounts are private and notifies clients when claims have not been paid in accordance with the accounts receivables policy

Demonstrates knowledge of and supports RR’s mission, vision, value statements standards, policies and procedures, operating instructions, confidentiality standards and the code of ethical behavior

Exercises excellent organization skills and is able to multitask will little oversight

Works independently and exercises good time management

Communicates professionally and respectfully with all departments

Ensure strict confidentiality of medical and financial records and follow HIPPA and confidentiality guidelines

Assist the team with Verification of Benefits as needed

Maintenance to include CEU education to keep CPC certification current

Other duties as assigned

Qualification

Medical Billing ExperienceMedical CodingHIPAA ComplianceMS Excel ProficiencyElectronic Medical RecordsCustomer Service SkillsTime ManagementOrganization Skills

Required

High school diploma, GED or equivalent

1 - 2 years of Medical Billing Experience within Substance Abuse or Mental Health

Completion with an Accredited Medical Billing & Coding Diploma Program

Excellent Customer Service skills

Strong working knowledge of inpatient & outpatient medical coding required

Excellent computer and reporting skills, including proficiency in data set filtering, sorting and grouping using MS Excel

Ability to manage multiple applications and records simultaneously while maintaining data integrity

Familiarity with electronic medical records and claims/practice management systems

Must be knowledgeable of applicable laws and regulations governing substance abuse treatment facilities and mental health including, but not limited to, HIPAA and Title 42 - Part 2