Medical Billing

Key Responsibilities:

Review patient charts and accurately assign ICD-10, CPT, and applicable modifiers.
Code and submit claims for neurosurgical consultations, office visits, procedures, injections, surgeries, and related services.
Handle commercial insurance, Medicare/Medicaid, and PIP/auto accident claims.
Verify insurance benefits, eligibility, authorizations, referrals, and claim requirements.
Prepare and submit electronic and paper claims and monitor them through payment or resolution.
Post insurance and patient payments accurately and reconcile accounts.
Work denials, rejections, underpayments, and unpaid claims, including researching and correcting billing errors.
Follow up with insurance companies, PIP carriers, attorneys, patients, and other responsible parties regarding outstanding balances.
Understand PIP claim requirements, including assignments of benefits, claim documentation, billing deadlines, medical necessity, and coordination of benefits.
Review medical records to ensure documentation supports the services billed.
Maintain accurate patient account information and insurance details.
Communicate with providers and clinical staff regarding documentation, coding, and billing questions.
Assist with accounts receivable follow-up and maintain appropriate aging reports.
Stay current with changes in coding guidelines, insurance policies, Medicare requirements, and Florida PIP regulations.
Maintain patient confidentiality and comply with HIPAA and applicable federal and state regulations.

Preferred Qualifications:

Previous medical billing and coding experience, preferably in neurosurgery, orthopedic, spine, pain management, or another surgical specialty.
Experience billing both health insurance and PIP/auto accident claims.
Knowledge of CPT, ICD-10-CM, HCPCS, modifiers, and medical necessity requirements.
Strong understanding of insurance denials, appeals, EOBs, and payment posting.
Excellent attention to detail and organizational skills.
Ability to manage a high volume of claims while meeting billing deadlines.
Experience with electronic medical records and practice-management/billing systems.
CPC, CCS, CPB, or other billing/coding certification is preferred but not required.