2 years experience as a pediatric coder and biller required.

Knowledge of Athena is a plus.

Responsibilities:

-Keep track of errors made by front desk causing claims rejection.

• Assist front desk staff with insurance eligibility and benefit determination, charge entry, and patient balances.
• Work closely with co-workers in department to ensure the day to day tasks are completed.
• Monitor claim rejections for denial patterns and incorrect reimbursement weekly for assigned insurance plans. Communicate any issues to manager as soon as they arise.
• Post insurance payments from explanation of benefit's remittance (EOB), process denials and take appropriate action to ensure payment is received.
• Ensure all payments received from the insurance carriers match the contractual allowances for services rendered.
• Obtain and review insurance reimbursement schedules quarterly. Communicate any discrepancies or adjustments to manager promptly.
• Work A/R for assigned insurance plans.
• Work insurance credit report monthly and request recoupment accordingly.
• Answer phone calls from parents and insurance companies.
• Work patient balance report monthly to obtain payment and apply monies collected. Review patient credits to initiate refund.
• Coordinate chart reviews with insurance companies.

- Review and analyze medical records and patient information to ensure accurate coding and billing
- Assign appropriate medical codes using ICD-10 and ICD-9 coding systems
- Verify insurance coverage and process claims for reimbursement
- Communicate with insurance companies, healthcare providers, and patients to resolve billing issues
- Follow up on unpaid claims and initiate collections process when necessary
- Maintain patient confidentiality and adhere to HIPAA regulations
- Update and maintain patient records in electronic billing systems

Requirements:
- High school diploma or equivalent; certification in medical billing/coding preferred
- Proficiency in medical terminology, ICD-10, ICD-9, and DRG coding systems
- Knowledge of medical office procedures and insurance billing practices
- Strong attention to detail and accuracy in coding and billing processes
- Excellent communication skills to interact with insurance companies, healthcare providers, and patients
- Ability to work independently and prioritize tasks in a fast-paced environment
- Familiarity with electronic health record (EHR) systems and medical billing software

Note: This job description is intended to provide a general overview of the position. It is not an exhaustive list of responsibilities, qualifications, or requirements. The employer reserves the right to modify the duties or requirements of the position as needed.

Job Types: Full-time, Part-time

Benefits:

• Paid time off

Schedule:

• 8 hour shift

Work Location: In person