Billing and Coding Specialist

POSITION TITLE: Billing and Coding Specialist

STATUS: Non-Exempt, Hourly

LOCATION: Angels Camp, California

SALARY RANGE: $25.56-$30.10

POSITION SUMMARY: 

Responsible for assuring that all Dental/Medical/Specialty patients of the MACT Health Board, Inc. are registered in the patient billing and collection system in accordance with billing and collection policy for the third party resources.  Employee must work in a positive and respectful manner with fellow employees. 

The position requires an awareness and keen appreciation of American Indian traditions, customs, and socioeconomic needs and the ability at all times to meet and deal effectively in contacts with Indian health organizations which requires tact, courtesy, discretion, resourcefulness and good judgment in handling functions of a sensitive nature. 

PRIMARY RESPONSIBILITIES: 

1. Account Representative for assigned location.
2. Data entry of patient, provider, and payer type information with speed and accuracy.
3. Ability to bill private insurance, Medi-Cal, Medicare, Medicare/Medi-Cal crossovers, Workers Compensation and private paying patients, billing primary and secondary payers.
4. Ability to prioritize tasks and complete assignments in a timely manner.
5. Precise adjudication of claims for members who are seen at the MACT Health Board clinics; the correct administration of benefits; paying attention to adjudication problems and errors, and solving associated problems.
6. Post and balance payments into the Electronic Patient Management billing software system.
7. Responsible for the correction of monetary amounts posted incorrectly to patients’ accounts or over payments as they appear on patients’ accounts. When possible, the credit amounts are reapplied to the account; refunds are issued where necessary.
8. Correspond with insurance companies, third party payers, and patients, collecting information, money or settling discrepancies and filing appeals.
9. Analyze for completeness, prepare and enter daily charges of super bills.
10. Meet deadlines for processing daily billings, contact related medical departments for clarification, receiving updates on Medi-Care, Medi-Cal and related providers for compliance.
11. Continue improvement of duties to streamline processing.
12. Research verification of benefits, change of guarantor, other opened encounters, etc.
13. Responsible for being current on any billing changes for the above agencies as assigned by the Billing Department Manager.
14. Maintain confidentiality with patient information at all times.
15. Other duties as assigned by the Direct Supervisor, Finance Director, and/or the Executive Director. 

KNOWLEDGE AND SKILLS FOR POSITION 

1. Knowledge of the Electronic Patient Management billing system, workflow dynamics, and modifications of the Electronic Patient Management billing software.
2. Knowledge and training in the HIPAA regulations related to patient care documentation, billing process and compliance to the regulations. 
3. Knowledge of State and Federal regulation as applies to billing for Medical, Dental and Behavioral Health services.

MINIMUM QUALIFICATIONS:

1. Have an AA Degree and/or equivalent, Have a minimum of 3 years’ experience in medical/dental billing.
2. ICD-9-CM  coding knowledge or experience is preferred. 

MANDATORY REQUIREMENTS: 

1. Pass an Occupational Health Screening, which includes passing a mandatory drug screening.
2. Possess a valid form of identification as listed on the U. S. Department of Justice I-9 form as processed using E-verify.
3. Proficient in problem resolution, detail analysis, and accuracy.
4. Ability to work as part of a professional team.
5. Good detail analysis, accuracy, oral and written communications, patience and tact required. 
6. Ability to prioritize tasks and complete assignments in a timely manner.
7. Current Member of AAPC.
8. Adhere to MACT policies at all times. 

DESIRED ABILITIES: 

1. Knowledge of medical, dental, or behavioral health billing CPT, ICD-9, & HCPCS Codes.
2. Knowledge of medical, dental, or behavioral health terminology.
3. Certified Professional Coder Certification.

1. Intermediate skill level of computers and Microsoft Word, Excel, and Outlook. 
2. Ability to pass a timed typing test at 45 wpm.
3. Ability to pass a timed 10 key test accurately. 

AMERICAN INDIAN PREFERENCE:

 Preference in filling of a vacancy will be given to qualified American Indian applicants in accordance with the Preference Act (Title 25, U.S. Code, Sections 472 & 473) and Public Law 93-638, provided the applicant has submitted appropriate verification of Indian preference for employment.  Other than the aforementioned requirement, the MACT Health Board, Inc. is an Equal Opportunity Employer. 

NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT:

MACT Health Board, Inc. is required to implement the Drug-Free Workplace Act of 1988, 45 CFR Part 79, Subpart F.  As such it is unlawful for employees to manufacture, distribute, dispense, possess, or use a controlled substance on the job site.  Employees who are reasonably suspected of violating this act may be subject to drug testing as a condition of employment.  Employer required fitness examinations shall include drug testing as evidence of employee and employer compliance with the Drug-Free Workplace Act.

Salary : $26 - $30