What are the responsibilities and job description for the Revenue Cycle Specialist III position at ENT Specialty Partners?
Billing Job Description
The Medical Billing and Coding Specialist performs complex billing functions which are integral to the revenue cycle team. Experience in medical billing and coding, terminology, CPT and ICD-10 is required. Using job knowledge, payer guidelines and contracts, coding guidelines and revenue cycle support will be necessary in performing daily functions to include electronic claim submission, auditing claims and notes for accuracy, working payer rejections and clearinghouse reports.
THIS IS NOT A REMOTE POSITION
Position Responsibilities
Essential Skills and Qualifications:
- THIS IS AN IN OFFICE ROLE, YOU WILL BE REQUIRED TO BE IN OFFICE MONDAY - FRIDAY 8-5PM*
The Medical Billing and Coding Specialist performs complex billing functions which are integral to the revenue cycle team. Experience in medical billing and coding, terminology, CPT and ICD-10 is required. Using job knowledge, payer guidelines and contracts, coding guidelines and revenue cycle support will be necessary in performing daily functions to include electronic claim submission, auditing claims and notes for accuracy, working payer rejections and clearinghouse reports.
THIS IS NOT A REMOTE POSITION
Position Responsibilities
- Review provider encounters and create claims daily.
- Auditing claim coding prior to submission.
- Reviewing notes and documents for verification of claim accuracy.
- Complying with medical guidelines and policies.
- Communicating and clarifying any claim information that is not clear.
- Recognizing and reporting any trends to management.
- Identify issues attributing to claims rejections and correct as appropriate.
- Work encounters without claims report
- Able to handle high volume while prioritizing job functions.
- Follow appropriate HIPAA guidelines.
- Ability to maintain confidentiality.
Essential Skills and Qualifications:
- Strong knowledge of ICD-10, HCPCS, CPT and Modifiers
- Knowledge of Revenue Cycle Processes and Workflow.
- Knowledge of payer policies, guidelines, portals and navigation.
- Ability to review and extract relevant information to assist in claim accuracy.
- Performs patient chart audits and provides coding feedback.
- Ensures compliance with medical coding policies and guidelines; understands the application of each code set.
- Works towards compliance in all aspects of coding, participates in compliance activities as requested and conducts/participates in provider coding reviews and education when required.
- Proficiency in computer skills including typing speed and accuracy.
- Ability to maintain a high level of integrity and confidentiality of medical information.
- Work well individually and in a team environment accomplishing set goals.
- Ability to prioritize and manage multiple responsibilities.
- Excellent written and verbal communication skills
- Experience with MS Office, EMR system eClinical Works a plus
- Minimum 3 years recent experience in both professional coding, billing and collections.
