What are the responsibilities and job description for the Medical Coding and Billing Specialist position at Quinault Wellness Center?
Are you a detail-oriented professional with a passion for healthcare billing and coding? We are looking for a skilled medical biller and/or coder to join our team. As a key member of our healthcare administration, youll play a critical role in ensuring accurate billing and coding for insurance claims and patient services. If you have experience with medical terminology, coding systems like ICD-10, CPT, and HCPCS, and you are committed to maintaining the highest standards of accuracy, we want to hear from you.
Quinault Community Health is located on the beautiful Olympic Peninsula, surrounded by the great outdoors. Locally we have many city, county, state, and federal parks. We are surrounded by an extravagant number of outdoor activities including hiking, camping, hunting, fishing, ocean beaches, lakes, rivers, bird watching and much more.
We offer our employees a wonderful benefits plan. All full-time employees are eligible for Medical, Prescription, Vision and Dental. If your plan is employee only, we will cover 100% of the premiums, you will also have the option to add dependents at an additional cost. We pay 100% of the premiums for our full-time employees for both short-term and long-term disability plans. We have a gracious employee leave program to include 14 holidays, paid annual leave and paid sick leave. We reimburse 100% of the costs of your licenses and certifications required for your position.
The Medical Coding Specialist is responsible for conducting audits and internal reviews of all medical coding and charge entries contained within patient Electronic Health Records. They verify all documentation for accuracy in preparation of submission for billing. The Medical Coding Specialist also works closely with Contract Health provided by Indian Health Services, referrals, and other departments to sign Quinault Wellness Center patients onto the Washington Health Benefit Exchanges for healthcare coverage.
This position will be scheduled for 40 hours a week, primarily Monday through Friday, however there may be an option to work on Saturdays if requested.
Essential Job Functions for the Medical Coder and Biller include but are not limited to:
Performs coding reviews on medical records to maintain subject matter expertise and completes internal audits of all medical coding and charge entries prior to submission for processing.
Maintains contact with staff within all Wellness Center departments to obtain additional patient information to document and process billings.
Analyzes all billing and claims for accuracy and completeness; conducts follow-up and corrective actions on any issues identified.
Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall Wellness Center protocols, and are following federal, state, and payer regulations, guidelines, and requirements.
Keeps up to date with all insurance carrier rule changes and distributes the information within the Wellness Center practice.
Understands and remains updated with current coding and billing regulations and compliance requirements.
Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
Checks eligibility and benefit verification of all Wellness Center clients.
Contributes to positive team environment that fosters open communication, sharing of information, continuous improvement, and optimized medical coding results.
Aids clients and their families in the application process through the Healthcare Exchange; facilitates completion of applications for subsidies or cost shared options, for Medicaid Program where eligible, or for full premium coverage when over income for Medicaid or subsidized coverage.
Educates clients on how to select a health insurance plan.
Explains terms and conditions for plans, costs, payment options, and penalties.
Instructs patients on how coverage will interact with current access to healthcare through Indian Health Services, Tribal Programs, or Indian Programs.
Ensures all patient information is accurate and complete; conducts appropriate entries into the Electronic Health Record system.
Creates and maintains all documentation regarding patient confidentiality (HIPAA, 42 CFR Part 2, etc.).
Performs other duties as assigned.
Adheres to QCH and QWC Policies.
Required:
Associates degree, preferably in a healthcare-related field or an equivalent combination of education and experience may substitute for the required degree.
Medical Coding Certification
Three (3) years of experience working in a medical setting
Knowledge and understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare, and strong knowledge of Washington and Federal payer regulations.
Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, transcription, designing forms, and other office procedures and terminology.
Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Knowledge and adherence to state (RCW, WAC) and federal confidentiality regulations (42 CFR part 2). Applicants must always conduct self ethically and professionally.
Knowledge of HIPAA and PHI requirements.
Knowledge of common office and administrative procedures.
Skills in the operation of a personal computer and standard office programs and equipment.
Ability to work in a cross-culture environment and understands the social and cultural context of the patients at the Quinault Wellness Center, understanding the role of trauma, historical, community, family, and personal experience in wellness and recovery.
Must pass criminal background investigation, reference inquiry, and vaccine mandate attestation requirements of either having been vaccinated or present documentation needed for a medical or religious exemption.
License Requirements:
Must maintain a valid Washington State Drivers License and must be insurable through our company.
Physical & Mental Requirements:
While performing these job duties, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is required to be able work at a computer work station during their scheduled shift. Employee is required to have in-person interaction with patients. The employee occasionally is required to stand; and stoop, kneel, crouch, or crawl.
Employees must be able to report to work on time and work their full scheduled shift.
Quinault Community Health is located on the beautiful Olympic Peninsula, surrounded by the great outdoors. Locally we have many city, county, state, and federal parks. We are surrounded by an extravagant number of outdoor activities including hiking, camping, hunting, fishing, ocean beaches, lakes, rivers, bird watching and much more.
We offer our employees a wonderful benefits plan. All full-time employees are eligible for Medical, Prescription, Vision and Dental. If your plan is employee only, we will cover 100% of the premiums, you will also have the option to add dependents at an additional cost. We pay 100% of the premiums for our full-time employees for both short-term and long-term disability plans. We have a gracious employee leave program to include 14 holidays, paid annual leave and paid sick leave. We reimburse 100% of the costs of your licenses and certifications required for your position.
The Medical Coding Specialist is responsible for conducting audits and internal reviews of all medical coding and charge entries contained within patient Electronic Health Records. They verify all documentation for accuracy in preparation of submission for billing. The Medical Coding Specialist also works closely with Contract Health provided by Indian Health Services, referrals, and other departments to sign Quinault Wellness Center patients onto the Washington Health Benefit Exchanges for healthcare coverage.
This position will be scheduled for 40 hours a week, primarily Monday through Friday, however there may be an option to work on Saturdays if requested.
Essential Job Functions for the Medical Coder and Biller include but are not limited to:
Performs coding reviews on medical records to maintain subject matter expertise and completes internal audits of all medical coding and charge entries prior to submission for processing.
Maintains contact with staff within all Wellness Center departments to obtain additional patient information to document and process billings.
Analyzes all billing and claims for accuracy and completeness; conducts follow-up and corrective actions on any issues identified.
Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall Wellness Center protocols, and are following federal, state, and payer regulations, guidelines, and requirements.
Keeps up to date with all insurance carrier rule changes and distributes the information within the Wellness Center practice.
Understands and remains updated with current coding and billing regulations and compliance requirements.
Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
Checks eligibility and benefit verification of all Wellness Center clients.
Contributes to positive team environment that fosters open communication, sharing of information, continuous improvement, and optimized medical coding results.
Aids clients and their families in the application process through the Healthcare Exchange; facilitates completion of applications for subsidies or cost shared options, for Medicaid Program where eligible, or for full premium coverage when over income for Medicaid or subsidized coverage.
Educates clients on how to select a health insurance plan.
Explains terms and conditions for plans, costs, payment options, and penalties.
Instructs patients on how coverage will interact with current access to healthcare through Indian Health Services, Tribal Programs, or Indian Programs.
Ensures all patient information is accurate and complete; conducts appropriate entries into the Electronic Health Record system.
Creates and maintains all documentation regarding patient confidentiality (HIPAA, 42 CFR Part 2, etc.).
Performs other duties as assigned.
Adheres to QCH and QWC Policies.
Required:
Associates degree, preferably in a healthcare-related field or an equivalent combination of education and experience may substitute for the required degree.
Medical Coding Certification
Three (3) years of experience working in a medical setting
Knowledge and understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare, and strong knowledge of Washington and Federal payer regulations.
Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, transcription, designing forms, and other office procedures and terminology.
Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Knowledge and adherence to state (RCW, WAC) and federal confidentiality regulations (42 CFR part 2). Applicants must always conduct self ethically and professionally.
Knowledge of HIPAA and PHI requirements.
Knowledge of common office and administrative procedures.
Skills in the operation of a personal computer and standard office programs and equipment.
Ability to work in a cross-culture environment and understands the social and cultural context of the patients at the Quinault Wellness Center, understanding the role of trauma, historical, community, family, and personal experience in wellness and recovery.
Must pass criminal background investigation, reference inquiry, and vaccine mandate attestation requirements of either having been vaccinated or present documentation needed for a medical or religious exemption.
License Requirements:
Must maintain a valid Washington State Drivers License and must be insurable through our company.
Physical & Mental Requirements:
While performing these job duties, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is required to be able work at a computer work station during their scheduled shift. Employee is required to have in-person interaction with patients. The employee occasionally is required to stand; and stoop, kneel, crouch, or crawl.
Employees must be able to report to work on time and work their full scheduled shift.
