What are the responsibilities and job description for the Billing & Coding Specialist position at Southeast Healthcare?
Southeast Healthcare is seeking a detail-oriented Billing & Coding Specialist to support accurate medical coding and overall revenue cycle operations within our FQHC. This position is responsible for reviewing and assigning medical codes to ensure compliance, accuracy, and timely reimbursement, while collaborating closely with clinical and revenue cycle teams.
Essential Functions:
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Review clinical documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes for diagnoses and procedures
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Ensure codes are properly sequenced and compliant with federal, state, and payer regulations, including Medicare and Medicaid requirements
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Communicate with providers and clinical staff to clarify or obtain necessary documentation
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Research and resolve complex or unusual coding scenarios using current coding resources and guidelines
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Review patient charts and related documentation for completeness, accuracy, and compliance
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Maintain current knowledge of coding updates, guidelines, and regulatory changes to ensure all codes used are current and active
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Support the Revenue Cycle Management team as needed to address claim issues, denials, and audits
Qualifications:
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Associate degree in Health Information Management or Medical Billing & Coding required.
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Coding certification (CPC) with at least 2 years of coding experience required.
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Experience with insurance claims submission, payment posting, and denial management.
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Familiarity with Medicare, Medicaid, and commercial payer regulations.
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Proficiency in electronic health record (EHR) systems and billing software.
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Familiarity with FQHC's, behavioral health coding, and add-on modifiers strongly preferred.
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High attention to detail with strong analytical and problem-solving skills.
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Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
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Strong written and verbal communication skills