Billing/Coder

Description
PRINCIPAL DUTIES AND RESPONSIBILITIES:

Perform billing/coding/collections duties, including review and verification of patient account information against insurance program specifications.
Evaluates medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes, in addition to other documentation, accurately reflect and support the outpatient visit.
Interprets medical information such as diseases or symptoms in addition to diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10-CM and CPT codes.
Reviews Medicaid and Medicare reimbursement claims for completeness and accuracy before submission to minimize claim denials. Ensures that all data complies with legal standards and guidelines.
Assist in the posting of Medicare, GHI, and all other INS payments as needed.
Provides technical guidance to the clinical providers and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to the approved coding principles/guidelines.
Educate and advise staff on proper code selection, documentation, procedures, and requirements.
Contact patients regarding account balances and payment plans.
Other duties will include special projects as assigned by the supervisor or CFO.

Requirements

KNOWLEDGE, EDUCATION, SKILLS, AND ABILITIES REQUIRED:

H.S graduate or equivalent; B.A. preferred.
2 + years of medical coding and administrative experience necessary; must be detail oriented and organized.
Familiarity with ICD-10-CM codes and procedures
Knowledge of eClinical Works preferred.
Working knowledge of medical terminology preferred
Strong knowledge of database programs and MS Office including Word, Excel, and Access a plus.
A high energy level, initiative, and a stickler for details.
Medical Billing/Coding certified a plus.