Physician Billing & Coding Specialist

Position: Physician Billing & Coding Specialist I
## Physician Billing & Coding Specialist IApplylocations:
US-FL-Daytona Beachtime type:
Full time posted on:
Posted Todayjob requisition :
JR104559

Day (United States of America)
Physician Billing & Coding Specialist IThe Physician Billing & Coding Specialist I is responsible for supporting the professional billing lifecycle, including physician coding, charge review and reconciliation, billing, and A/R follow-up. This role reviews clinical documentation for accurate ICD-10, CPT, and HCPCS code assignment; ensures compliance with regulatory and payer requirements; resolves patient and third-party account issues; and serves as a liaison between providers, payers, and patients to promote timely, accurate reimbursement.

Education
· High school diploma or equivalent required
· Associate’s or Bachelor’s degree preferred (Health Information Management, Business, or related field)
Experience
· Minimum of two (2) years’ experience in healthcare coding, billing, patient accounting, or revenue cycle operations
· Hospital or physician billing experience preferred

Certifications (Required)
· CPC, CCS-P, CCSP, or equivalent coding certification
· Certification required within 6 months of hire date SKILLS, EXPERIENCE AND LICENSURE:
· 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 skills with physicians, colleagues, and ancillarydepartments required
· The ability to organize, prioritize, analyze, and implement daily tasks; must be a self-starter
· The ability to handle multiple responsibilities and tasks in stressful situations
· The ability to maintain confidentiality; knowledge of HIPAA laws
· Proficiency with billing systems, specifically Epic

DUTIES AND RESPONSIBILITIES:

Physician Coding & Documentation Integrity
· Review physician medical records to extract and assign appropriate ICD-10, CPT, and HCPCS codesfor professional billing.
· Maintain knowledge of Local and National Coverage Determinations (LCD/NCD), payer policies, and regulatory changes.
· Comply with internal coding standards, government regulations, and third-party payer requirements.

Billing & Accounts Receivable Management
· 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. Other Responsibilities
· 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 time frames.
· 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.