Location: Remote - Florida
Department: Department of Revenue Integrity
Work Type: Full Time
Shift: Shift 1/7:00:00 AM to 3:30:00 AM
Minimum to Midpoint Pay Rate: $22.78 - $29.62 / hour
Summary
Resolves billing issues, and provides coverage guidelines for billable services to reduce or prevent future claim denials. Employs Craneware Online, EPIC WQ workflows, and other accredited resources for assigned cost center(s) to identify potential reimbursement opportunities in a proactive manner. Ensures the appropriate bundling or unbundling of charges, and applicable modifiers applied so that all charges that are submitted result in optimal reimbursement while following applicable billing, coding and reimbursement regulations within respective areas. Interacts with other departmental staff, i.e. BO, HIM and ADT for resolution of third party payer billing disputes. Additionally, resolves CCI edits as appropriate, reviews Medicare intermediary and other third party payer bulletins to keep current on billing requirements and APC payment status and changes. Communicates relevant information to all applicable department personnel. Communicates results through daily interaction and monthly status meeting to the department team. Provides other support as needed.Requirements
Educational Requirements
| Degree/Diploma Obtained | Program of Study | Required/ Preferred | and/or |
| High School Diploma or Equivalent | Required | ||
Additional Requirements
Prefer Bachelor Degree or higher formal education, 2 years formal education post high school in clinical, financial, or coding program.Experience Requirements
| Minimum Years Required | Area of Experience | Required/ Preferred | and/or |
| 3 Years | Healthcare | Required | |
Additional Requirements
3 experience in healthcare-related field, in hospital billing, coding and/or charging/reimbursement-related capacity. Additional clinical experience in related field a plus.State of Florida Licensure Requirements
| Licenses | Required/ Preferred | and/or |
| Not Required | ||
Certifications/Registration Requirements
| Certificates/Registrations | Required/ Preferred | and/or |
Additional Requirements
Coding certification preferred to include CPT, HCPCS, ICD9-10, and DRGUS:FL:Fort Myers
High school diploma or equivalent required; 3 years of healthcare experience in hospital billing, coding, charging, or reimbursement; coding certification preferred.
Key Responsibilities
- resolving billing issues
- reviewing payer bulletins
- optimizing reimbursement
Skills & Tools
Craneware Online, EPIC WQ, CPT, HCPCS, ICD9-10, DRG
Job Details
- Category: Finance and Accounting
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — Fort Myers, Florida, United States
- Salary: USD 47,382 – 61,609 / year
- Languages: English
About Lee Memorial
A healthcare organization providing hospital and related patient care services. — Industry: Healthcare