Medical Billing Coding Specialist
Medical Billing Coding Specialist
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1 Vacancy
Job Description
Job Title: Medical Billing and Coding Specialist
Job Status: Fulltime
Job Summary: Under close supervision the Medical Billing and Coding Specialist is responsible for processing health insurance claims for services provided at all clinics. Employee is responsible for submitting claims for reimbursement and coach healthcare providers to achieve optimal reimbursements.
Essential Duties and Responsibilities:
- Verify the providers determination of services provided and patient diagnoses via office and operative notes
- Enter charges in the billing system and/or reviews
- Maintain complete knowledge and comply with all relevant insurance CPT coding and diagnosis guidelines disseminating info to staff and providers as necessary
- Review quarterly provider audits researching proper coding when necessary and working with coding and compliance as needed
- Create relationships with external organizations that allow for streamlining and quick resolution of billing matters for patients
- Document conversations with insurance companies and patients
- Audit agency reports for procedures with office billing to ensure accuracy of billing to payers
- Audit EMR entries to verify correct insurance and demographic information
- Attend regularly scheduled meetings
- Coordinate and follow through with special projects as assigned
- Create a positive professional serviceoriented work environment for staff clients and family members by supporting the ACCESS mission and core values statement
- Use a special coding system to choose diagnosis and procedure codes
- Enter the correct codes into patients electronic health records
- Review claims to make sure coding is accurate
- Work with other staff members to ensure accuracy
- Enter insurance claims into specialized billing programs
- Interact with patients when insurance matters need to be clarified
- Follow up with insurers about any late payments
- Track payments to make sure reimbursements are received on time
- Keep in tune with changes and advancements in the field
- May be responsible for credentialing
- Operate standard office equipment and use required software applications
- Perform other duties and responsibilities as assigned
Knowledge Skills and Abilities:
Knowledge of:
- Billing and managed care department basic services and hours of operation to respond to customer requests accurately
- Medical including surgical terminology and procedures at the level needed to perform job responsibilities including understanding of CPT and ICD9/ICD10 coding
- Rules and regulations regarding insurance claim submissions
Skill in:
- Operating standard office equipment and using required software applications for program area and other applications including Microsoft Office
- Critical thinking with the ability to effectively problem solve (e.g. able to determine if a patient issue requires immediate provider attention if there are significant changes to the patient history or other clinical issues that are presented)
- Strong customer service skills
- Strong multitasking skills
- Organizational and time management skills to effectively juggle multiple priorities time constraints and large volumes of work
Ability to:
- Operate a standard desktop and Windowsbased computer system including but not limited to electronic medical records Microsoft Word Excel Outlook intranet and computer navigation
- Use other software as required while performing the essential functions of the job
- Communicate effectively with both written and verbal forms including proper phone etiquette
- Work collaboratively in a teamoriented environment; courteous and friendly demeanor
- Work effectively with various levels of organizational members and diverse populations including ACCESS staff patients family members insurance carriers outside customers vendors and couriers
- Crosstrain in other areas of practice in order to achieve smooth flow of all operations
- Exercise sound judgment and problemsolving skills specifically as it relates to resolving billing and coding problems
- Handle patient and organizational information in a confidential manner
- Work under minimal supervision
Educational/Previous Experience Requirements:
- Minimum Degree Required:
- Associate degree
- Bachelors degree preferred
and
- At least 35 years previous clinical billing experience or equivalent combination of education experience and/or training approved by Human Resources.
Licenses/Certifications:
- Licenses/Certifications Required at Date of Hire:
- Medical Billing and Coding Certificate or Degree in field Certified Professional Coder (CPC) Nationally Registered Certified Coding Specialist (NRCCS) or Registered Health Information Technician (RHIT)
Working Conditions:
Hours: Normal business hours some additional hours may be required
Travel Required: Local travel may be required
Working Environment: Climate controlled office
Required Experience:
Unclear Seniority
Employment Type
Full Time
