3 jobs found in St. Petersburg

Job Description Job Description Description: Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding. This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands-on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff. Key Responsibilities Perform audits of outpatient surgical encounters, including operative reports and related documentation Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs Ensure compliance with CMS, payer, and official coding guidelines Identify trends, risks, and educational opportunities based on audit findings Provide written audit feedback and coding education to support quality improvement Collaborate with coding leadership and...

Join Our Thriving Pediatric Orthopaedic Group! Are you a detail-oriented insurance collector passionate about ensuring accurate billing in a fast-paced environment? We are seeking a highly motivated Billing Specialist to join our revenue cycle management team and play a vital role in bringing patient accounts to a zero balance. Role Overview: In this role, you will oversee the billing process for healthcare services, ensuring accurate claim submissions and full payment collection. Your responsibilities will include reviewing rejected claims, making justified adjustments, handling appeals for denied or underpaid claims, creating monthly Accounts Receivable reports, and resolving issues with provider representatives. What You'll Do: Independently: Analyze claim denials and take corrective action, including corrected claims, reconsiderations, and appeals. Apply accurate adjustments based on insurance guidelines and contracts. Manage secondary insurance and...

Job Description Job Description Medical Billing Specialist Florida Pediatric Associates is seeking an experienced Medical Billing Specialist to join the team. Hybrid Work : Employee will be able to work 4 days from home and 1 from the office. Top benefits package includes: 90% Employer Paid Employee Medical Dental Vision 100% Employer Paid STD & LTD Supplemental Insurance Options 7 Paid Holidays 401k Plan and Amazing Work Environment Education: High School Diploma or GED Certification in medical coding (CPC) preferred Working knowledge of Medicare and Florida Medicaid coding rules and regulations including but not limited to as National Correct Coding Initiative edits and payer guidelines. Working knowledge of the current International Classification of Diseases (ICD), Current Procedural Technology (CPT) and Healthcare Common Procedure Coding System (HCPCS) coding and terminology. Experience: Two of more years of medical coding and/or...