Clinic Claims Coordinator
5 days ago
Tallahassee
Job Description Position Summary: The Healthcare Claims Creator is responsible for accurately generating and preparing claims for submission to insurance carriers based on documentation from providers. This role plays a critical part in the revenue cycle by ensuring all required information is verified and compliant with payer requirements, ultimately supporting timely reimbursement and reducing denials. Key Responsibilities: • Review provider documentation and billing notes to create accurate insurance claims., • Ensure proper CPT, and ICD-10 codes are selected based on services rendered., • Validate patient demographics, insurance eligibility, and referral or authorization details prior to claim creation., • Apply internal billing rules and payer-specific guidelines to claims after submission., • Flag incomplete or inconsistent documentation for coder or provider review as needed., • Communicate with coders and billing staff to resolve any issues that may delay claim creation., • Meet productivity and accuracy benchmarks set by the department., • Follow HIPAA and organizational standards to protect patient information., • High School Diploma or equivalent required., • Minimum of 2 year of experience in a healthcare billing or administrative support role preferred., • Familiarity with medical terminology, insurance billing practices, and revenue cycle processes., • Basic understanding of CPT, ICD-10, and HCPCS coding., • Proficient in Microsoft Office and experience with practice management systems or electronic health records (EHRs)., • Strong attention to detail and organizational skills., • Effective communication and problem-solving skills., • Certification or coursework in medical billing, coding, or healthcare administration., • Prior experience working with payer-specific billing rules and edits., • Experience in a specialty practice (e.g., orthopedics,) is a plus., • This is a remote position, but not all states are eligible. Candidates must reside and be authorized to work in one of the approved states: AR, AL, AZ, CO, FL, GA, IL, NV, NM, OK, SC, TN, TX, VA