Job summary
Job post source
This job is directly from Florida Blue
Job overview
The PrePay Coder, CPC at Florida Blue is an intermediate-level role focused on analyzing high risk claims to ensure accurate payment and control medical costs.
Responsibilities and impact
The role involves independently reviewing high risk claims using coding expertise, validating medical documentation, ensuring compliance with contracts and regulations, communicating with providers, documenting issues, and participating in process improvement projects.
Compensation and benefits
The position offers an annual salary range of $63,800 to $103,600 with typical hiring range $63,800 to $79,700, comprehensive medical, dental, vision, life insurance, income protection, retirement plans with employer match, paid time off, and wellness programs.
Experience and skills
Candidates must have 4+ years of medical billing and coding experience, CPC certification, knowledge of ICD-10, CPT, HCPCS coding, E&M guidelines, attention to detail, and strong communication skills; preferred qualifications include analytics, consulting, clinical experience, and familiarity with Florida Blue systems.
Career development
Florida Blue supports employee wellbeing and offers regular pay reviews with performance considerations and opportunities for incentive compensation, fostering professional growth.
Work environment and culture
Florida Blue promotes a Be Well, Work Well, GuideWell culture emphasizing individual and team wellbeing, inclusivity, and community service.
Company information
Florida Blue is a health insurance company focused on serving members and communities with comprehensive benefits and wellness programs.
Job location and travel
This is a remote position based in Florida.
Unique job features
The role uniquely combines medical coding expertise with claims payment integrity and direct provider interaction to control medical costs and improve claims processes.
Company overview
Florida Blue, a subsidiary of GuideWell Mutual Holding Corporation, is a leading health solutions company based in Jacksonville, Florida. It primarily operates as a health insurance provider, offering a range of plans including individual, family, and Medicare options. The company generates revenue through premiums, administrative fees, and investment income. Founded in 1944, Florida Blue has a rich history of adapting to healthcare reforms and expanding its services to meet the evolving needs of its members.
How to land this job
Position your resume to highlight your Certified Professional Coding (CPC) certification and emphasize your 4+ years of experience in medical billing and coding, showcasing your expertise with ICD-10, CPT, HCPCS, and E&M coding guidelines relevant to Florida Blue's pre-payment claims analysis.
Emphasize your ability to independently analyze high-risk and high-dollar claims, your familiarity with medical terminology, and your experience with encoder systems and electronic medical records (EMR), as these are critical for ensuring claims payment integrity at Florida Blue.
Apply through multiple channels including Florida Blue’s official corporate careers site, LinkedIn, and other job boards where the PrePay Coder position is listed to maximize your chances of being noticed.
Connect with professionals in Florida Blue’s claims or payment integrity divisions on LinkedIn, using ice breakers like commenting on recent Florida Blue healthcare initiatives or asking about their experience with Florida Blue’s payment policies and systems such as Diamond or Prepay UI.
Optimize your resume for ATS by incorporating keywords from the job description such as 'Certified Professional Coding,' 'claims payment integrity,' 'medical billing and coding,' 'E&M coding guidelines,' and 'payment integrity review' to ensure your resume passes initial automated screenings.
Use Jennie Johnson's Power Apply feature to automate applying through multiple platforms, tailor your resume with the right keywords, and identify LinkedIn connections to network with, allowing you to focus more on preparing for interviews and refining your skills.
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