Medical Billing and Coding Specialist

Applicant Must Have:

• Reliable, punctual, and great customer service
• Collect, post and manage accounts payable
• Ability to function well in a fast-paced environment
• Submit claims to insurance company
• Must have strong knowledge in working appeals, reconsiderations
• Must be capable of working in high volume environment and produce clean claims
• Follow up on denials and re-processed properly
• Coincide procedure codes with diagnosis
• Review deliquiate account
• Ensure claims are paid according to contracted rates
• Excellent organizational as well as verbal and written communication skills
• Takes initiative
• Ability to work in a continuously changing environment, flexible
• Coding Certification through AHIMA or AAPC is required (CPC, CPC-A, CCA, CCS, CCS-P, RHIT, RHIA, etc.)
• High School Diploma required

Job Responsibilities:

• Reviews and verifies assigned codes and sequences diagnosis and procedures according to regulations (e.g., ICD-10-CM, CPT, HCPCS coding guidelines)
• Posting charges
• Patient billing and collections
• Claim review and follow through on all submissions
• Insurance verification and benefits check
• Trouble shooting denied claims
• A/R review and follow up
• Research and resolve billing problems and issues
• Contact physician’s offices for referrals and other pertinent records as needed
• Maintains up-to-date knowledge of coding and regulatory requirements to accurately assign codes for appropriate reimbursement of healthcare services
• Utilize web-based tools, coding books, and other available resources to facilitate providing insurance and regulatory companies with the required information
• Obtains medical records through EMR for reconsideration purposes
• Interacts with private and government payers to facilitate the prompt payment of accounts receivable
• Identifies past-due bills and sends for statement processing
• Assigns charges for self-pay patients, bills patients for balances, collect payments from patients via phone
• Identifies all denial trends and provides education of steps to prevent future avoidable denials
• Initiate/Manage all appeals on time
• Have an in-depth understanding of the explanation of benefits (EOB's)
• Other duties as assigned as deemed necessary

This is not an entry level position:

• Qualified candidate must have at least one year of medical billing experience
• Familiarity with Medicaid and commercial insurance billing procedures
• Must be knowledgeable of medical and insurance terminology
• Ability to work independently and perform assigned duties effectively and efficiently
• Knows how to navigate through EMR systems and Availity but not limited to
• Flexible, team player

Note: This job description is intended to provide a general overview of the position. Other duties may be assigned as necessary.

Job Types: Full-time, Part-time

Pay: $18.00 - $20.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• ICD-10: 1 year (Preferred)

Work Location: In person

Salary : $18 - $20