Job Description
Job purpose
Responsible for maintaining the professional reimbursement program. Ensure compliance with current payments and rules that impact billing and collection.
Duties and responsibilities
The Medical Billing Coder performs billing and computer functions, including patient & third party billing, data entry and posting encounters. Typical duties include but are not limited to:
Follow-up of any outstanding A/R all-payers, self-pay, and the resolution of denials
Prepares and submits clean claims to various insurance companies either electronically or by paper.
Handle the follow-up of outstanding A/R all-payers, including self-pay and /or the resolution of denials.
Answers question from patients, FHCHC staff and insurance companies.
Identifies and resolves patient billing complaints.
Prepares reviews and send patient statements and manage correspondence.
Handle all correspondence related to insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get the maximum payments and accounts and identify issues or changes to achieve client profitability.
Take call from patients and insurance companies regarding billing and statement questions.
Process and post all patient and/or insurance payments.
Reviewing clinical documentation and provide coding support to clinical staff as needed.
Qualifications
High School diploma or GED with experience in medical billing is required. A certified professional coding certificate, knowledge of third party billing requirements, ICD and CPT codes, and billing practices are also required. Excellent interpersonal and communication skills and ability to work as a member of the team to serve the patients is essential. Must be detail oriented and have the ability to work independently. Bi-lingual in English and Spanish highly preferred. FQHC/EPIC experience is desirable.
Direct reports
NONE