Medical Billing Coder

Reports to: Director of Revenue Services

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

OSHA Status

• Category III—Low Risk Position
• Generally works in an office environment with no exposure to bloodborne pathogens
• Potential exposure to hazardous waste and blood borne pathogens, clinical settings

Physical requirements

• Physical Demands: Requires walking, bending, sitting, standing, writing, reading, telephone use, data input into computer, pulling medical records,
• Mental Demands: Ability to cope with continual changing priorities under potentially stressful conditions
• Manual Dexterity Required:  Ability to use a keyboard, telephone.

American with Disabilities Requirements

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.