Description

The Medical Billing and Coding Specialist supports the delivery of healthcare services within the Clay County Jail. This position is responsible for accurately processing and managing billing for medical care provided to incarcerated individuals. Key responsibilities include verifying clinical documentation, assigning appropriate diagnostic and procedural codes, and ensuring all billing activities comply with federal and state regulations, correctional healthcare standards, and facility-specific protocols. The ideal candidate will demonstrate attention to detail, a strong understanding of medical coding systems (ICD-10, CPT, HCPCS), and the ability to navigate the regulatory landscape of correctional healthcare.

Requirements

• Review and verify accuracy of patient billing data and insurance information.
• Process claims for vendors’ (medical, dental, and mental health) services provided to incarcerated individuals.
• Use appropriate coding systems (ICD-10, CPT, HCPCS) to ensure accurate documentation and billing.
• Work closely with healthcare providers and administrative staff to verify medical records and service details.
• Ensure compliance with Medicare and contractual billing guidelines specific to CCSO agreements and MOUs.
• Processes inmate claims and adjusts rates according to agreements and Medicare fee schedules.
• Inputs medical fees assessed from processed medical claims for the cash account in accordance with agency policy.
• Prepare and maintain billing records, invoices, and reports according to facility and legal standards.