MEDICAL BILLING AND CODING SPECIALIST
JOB DESCRIPTION Fast-paced community health center seeks a positive, highly motivated Patient Billing Collection Specialist II who will… Review pending charges to ensure assignment of appropriate diagnosis and procedure codes Ensure accuracy and integrity of charges captured to reduce denials when billed to meet claim denial rate goal Post pending charges accurately within 48 hours of provider’s signature Act as a resource to physicians, administrators, and patients regarding coding compliance, health insurance claim policies, procedures and requirements. Function as liaison between patients and clinic staff on coding, claims, denials, and insurance related questions and issues. Post ERA insurance payments, post manual adjustments and apply Sliding Fee discounts Analyze insurance account receivable balances; resolve within ten days and document all activity and efforts made
- correction and resubmission of claim denials
- follow up on outstanding unpaid claims
- submission and processing of claim appeals
- submission of claims for write-offs / adjustments
- maintain insurance accounts receivable balances and days in AR goals
Request refunds for patients and/or insurance for any overpaid monies remaining in unapplied credits Request write offs for insurance denied visits due to timely filing, and patient balances over 121+ days deemed uncollectible. Job Specification and Qualifications:
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) designation required
- High School Diploma/GED required
- Minimum 1 year job experience or school equivalent required
- Required to understand and adhere to HIPAA Privacy and Security Compliance.
- Knowledge of medical, dental, and behavioral health coding (CPT and ICD-10), medical billing and procedures with Medicare, Medicaid, and third party insurance, medical terminology, documentation requirements, and regulatory requirements required.
- Knowledge and experience with the Practice Management System, Intergy preferred.
- Proficient use of computers, Microsoft Word and Microsoft Excel.
- Strong communication, verbal and written and interpersonal skills.
- Demonstrates behaviors that promote positive customer relations with staff, patients, and visitors.
Excellent Comprehensive Benefits:
- Competitive salary
- 100% Premium Free United Health Care core medical coverage
- 100% employer funded $50,000 life insurance
- Ten (10) paid holidays annually
- 20 PTO days annually
- Public Service Loan Forgiveness
- Employee Assistance Program (EAP)
- Optional supplemental coverage (short- and long- term disability)
Job Type: Full-time