Clinical Revenue Specialist: Physician Billing & Coding

Staff_02 Halifax Staffing Inc.; Daytona Beach (FL); On-site; USD 42,000 - 62,000; Full time

Job summary

Halifax Health in Daytona Beach, FL seeks a Day (United States) Physician Billing & Coding Specialist I to support the professional billing lifecycle. You will review clinical documentation for ICD-10, CPT, and HCPCS coding and ensure payer compliance while collaborating with providers, payers, and patients to promote timely reimbursement.

Responsibilities include coding integrity, claims processing, AR follow-up, audits, and thorough documentation in the billing system.

Qualifications

• Knowledge of ICD-10, CPT, HCPCS, HCFA-1500 and professional billing practices.
• Knowledge of Local Coverage Determinations and National Coverage Determinations (LCD/NCD) medical necessity requirements.
• Knowledge of regulatory and third-party payer requirements.
• Professionalism in interpersonal communication with physicians, colleagues, and ancillary departments.
• Ability to organize, prioritize, analyze and implement daily tasks; must be a self-starter.
• Ability to handle multiple responsibilities and tasks in stressful situations.
• Maintain confidentiality; knowledge of HIPAA laws.
• Proficiency with billing systems, specifically Epic.

Responsibilities

• Review physician medical records to extract and assign appropriate ICD-10, CPT, and HCPCS codes for professional billing.
• Maintain knowledge of LCD/NCD, payer policies, and regulatory changes.
• Comply with internal coding standards, government regulations, and third-party payer requirements.
• Process professional claims accurately and timely in accordance with payer-specific guidelines.
• Correct and resubmit rejected, denied, or pending claims; follow up with insurance carriers to ensure timely payment.
• Analyze remittances and explanation of benefits (EOBs) to determine appropriate payment application, adjustments, or patient responsibility.
• Assist with internal and external payer and compliance audits
• Assign and track follow-up dates to prevent timely-filing issues.
• Maintain accurate documentation and notes in billing system.
• Work assigned account work queues daily to ensure timely resolution.
• Respond to written and electronic correspondence within required timeframes.
• Adhere strictly to HIPAA, organizational ethics standards, and corporate compliance policies.
• Maintain confidentiality of all patient and financial information.
• Demonstrate ethical and professional conduct in all interactions.
• Assist coworkers and departments as needed.
• Maintain flexibility to support multiple functional; Revenue Cycle areas.
• Perform additional duties as assigned by management.

Skills

ICD-10/CPT/HCPCS

LCD/NCD knowledge

Regulatory/payer knowledge

Interpersonal communication

Time management

HIPAA confidentiality

Epic billing systems

Education

High school diploma or equivalent

Associate’s or Bachelor’s degree preferred (Health Information Management, Business, or related field)

Tools

Epic

Job description

Halifax Health in Daytona Beach, FL seeks a Day (United States) Physician Billing & Coding Specialist I to support the professional billing lifecycle. You will review clinical documentation for ICD-10, CPT, and HCPCS coding and ensure payer compliance while collaborating with providers, payers, and patients to promote timely reimbursement.

Responsibilities include coding integrity, claims processing, AR follow-up, audits, and thorough documentation in the billing system.