Billing & Coding Specialist — Denials & Audits

MCR Health, Inc; Bradenton (FL); On-site; USD 45,000 - 65,000; Full time

Job summary

MCR Health, Inc. in Bradenton, FL is seeking a skilled Medical Coder to review provider documentation and assign accurate ICD-10 and CPT codes for payer submissions.

You will resolve denials, audit charts, and support clinical staff with coding accuracy, while ensuring confidentiality and compliance across managed care and private payers. The role requires at least 2 years of insurance/reimbursement experience, familiarity with ICD-10/CPT, and a willingness to obtain coding certification within

Qualifications

• High School Graduate or GED minimum.
• Minimum of two years of experience in insurance and reimbursement.
• Proficiency in operating a computer, calculator, copier, and other standard office equipment.
• Proficient in the Microsoft Office Suite.
• Bilingual: Spanish/English is a plus.
• Working knowledge of medical terminology (preferred).
• Working knowledge of ICD-10 and CPT codes (minimum of 1 year required).
• Coding certification preferred; must obtain certification within 6 months of hire (or as assigned by management).
• Working knowledge in Managed Care, Government Payers, and Private Payers (preferred).
• Reliable transportation to/from site and ability to be moved between sites as assigned if onsite position.
• Ability to maintain patient confidentiality required.

Responsibilities

• Review provider documentation in medical records and assign the most accurate diagnosis and procedure codes that meet payer coding and billing requirements.
• Add missing codes to claims supported by provider chart documentation for submission of claims that reflect the severity and intensity of care rendered.
• Query providers to obtain clarifying documentation to improve the specificity and completeness of the data used to assign diagnosis and procedure codes.
• Review denials and recode claims as appropriate for resubmission.
• Complete chart auditing to improve coding accuracy as assigned.
• Track and trend denied claims, errors, and other assigned issues and communicate them to the appropriate Revenue Cycle leader.
• Serve as a coding and documentation resource for providers and clinical staff.

Skills

Medical terminology knowledge

ICD-10 and CPT coding knowledge

Bilingual: Spanish/English

Education

High School Diploma or GED

Coding certification (preferred; must obtain within 6 months)

Tools

Microsoft Office Suite

Job description

MCR Health, Inc. in Bradenton, FL is seeking a skilled Medical Coder to review provider documentation and assign accurate ICD-10 and CPT codes for payer submissions.

You will resolve denials, audit charts, and support clinical staff with coding accuracy, while ensuring confidentiality and compliance across managed care and private payers. The role requires at least 2 years of insurance/reimbursement experience, familiarity with ICD-10/CPT, and a willingness to obtain coding certification within