Medical Billing & Coding Specialist en Clay County Sheriff's Office (FL), FL

About the Department

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.

Position Duties

• 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.
• Track claim statuses, follow up on unpaid claims, and resolve discrepancies in a timely manner.
• Liaise with third-party payers, contractors, or governmental agencies as needed.
• Respond to internal and external inquiries regarding billing, coding, and payment issues.
• Assist by providing patient information to insurance, such as the Affordable Care Act, for medical coverage for the incarcerated individual.
• Maintains a record of qualified insurance coverage for the incarcerated individual.
• Submits patient insurance to outside providers to reduce cost of care.
• Review and process medical bills and claims to ensure accuracy and compliance with policies.
• Communicate with inmates, medical staff, and insurance representatives to resolve billing issues or discrepancies.
• Reports cost savings, hospital totals, and amounts paid in the monthly DART report.
• Maintain confidential and accurate records of billing, payments, and insurance documentation.
• Ensure compliance with relevant laws, regulations, and institutional policies related to inmate healthcare.
• Maintain patient confidentiality and comply with HIPAA and correctional facility policies.
• Stay informed of changes in billing regulations specific to correctional healthcare.
• Maintains Biohazard Waste manifest records.
• Maintains licensing with DOH for biohazard waste and inspection records.
• Reports identified as potential maintenance, safety, and/or non-compliance findings, hazards, or incidents to the appropriate personnel or department.
• Responds to supervision, guidance, direction, and feedback from executive staff and superiors in a receptive manner and in accordance with agency policies.
• Conducts themselves in polite, helpful, courteous, ethical, and professional manner abiding by the established code of ethics and demonstrates a professional image when engaged in any activity with the public.
• Cultivates positive working relationships with colleagues and other agency units to enhance work area output and services in line with agency policies.
• Demonstrates an understanding, consideration, and respect of cultural, religious, and gender differences when interacting with the public and coworkers.
• Performs other duties as assigned.

Minimum Qualifications

LICENCES, EDUCATION AND EXPERIENCE REQUIREMENTS:

• High school diploma or equivalent. 
• Associate degree or certification in medical billing/coding (Certified Medical Billing and Coding Specialist) required, or equivalent work experience in accordance with FSS 112.219.
• Three (3) years of experience in medical billing/claims preferably in the correctional setting.
• Proficiency in medical terminology and EMR systems.
• Strong understanding of correctional healthcare practices.
• Detail-oriented with excellent organizational and problem-solving skills.
• Ability to work independently and communicate professionally with staff and external agencies.
• Current CPR Certification, or may obtain after hire
• Speak and understand the English language
• Internal candidates must have successfully completed their probationary period
• Internal candidates with punitive disciplinary action within 365 days are ineligible
• Internal candidates must have completed applicable CCSO FTEP requirements 
• The following items (or authorized equivalents) may be required at various steps in the application process: 
  1. Driver's License
  2. Birth Certificate
  3. Social Security Card
  4. Form DD214 for all periods served in the military
  5. GED or High School Diploma and Sealed Transcripts from the highest level of education
  6. FDLE Authority for Release (notarized)

Other Qualifications

Salary is negotiable for full-time positions prior to initial hire, if requested, based on verified experience up to step five (5) of the assigned pay grade. Current employee salary changes are determined based on internal methodology. Please contact Human Resources with any questions. 

Benefits for full time positions include Florida Retirement System, a full suite of very affordable health/life/dental/vision benefits, ancillary insurance policies, college reimbursement, and more. Benefits are effective the 1^st of the month after a full 30 days worked. For more information on benefits, please visit https://www.claycountygov.com/government/personnel-services/employee-benefits. 

The duration of the selection process may range from one (1) to three (3) months and may vary based on the number of applicants and/or urgency of filling the vacancy. 

Applicants are reminded to take note of the close date listed on this job posting. Interviews are not typically requested prior to this date.

If accommodations are required throughout any portion of the hiring process, please contact our Human Resources team at [email protected]. 

All positions at the Clay County Sheriff’s Office have testing requirements to determine eligibility. All selected candidates will complete a drug screening, polygraph examination and a comprehensive background investigation as a condition of employment. Sensitive and/or confidential aspects of candidates’ personal lives may be explored during this process (including driving, drug usage, criminal, employment, and residential histories). 

Any job qualifications or requirements listed in this job posting are susceptible to written and/or physical testing. This testing may be included in the competitive selection process.

Reapplication/Retesting of discontinued or disqualified applicants is available after 365 days.  

This posting has been reviewed by Human Resources and found to be job related and non-discriminatory. If you are interested in this position, please submit your electronic application at https://www.claysheriff.com/departments/employment/.