Billing Specialist

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

Why MCR Health?

A career at MCR Health offers exciting opportunities with one of the largest healthcare companies in the areas we serve. Now, more than ever, we are looking for exceptional people to support our passion to provide "Exceptional Care to Everyone, Every Time" and our mission to serve everyone. Whether you provide direct patient care or work in other areas of the company, you can find a home here and grow your career while serving with your heart.

Job Overview

Monday–Friday schedule, 9 holidays, generous vacation and sick policy, and onsite corporate gym.

Work Location

Bradenton, FL

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.

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.

Additional Information

MCR Health is a drug‑free workplace. All job applicants selected for employment are required to submit to a pre‑employment drug test and background check.