Medical Billing and Coding Specialist

POSITION SUMMARY

This position performs advanced billing and collection activities. Make collection calls, verifying accuracy and completeness of claims, contact insurance companies regarding expediting payments from various payers for provider’s services. Handles discounts, adjustments and charge corrections.

ABOUT THE COMPANY

We are Washington Care Clinic and provide chiropractic and regenerative medicine and we are growing by the day. Our mission is to help our patients to achieve optimal health and happiness through pain-free living and natural healing solutions. We are Disciplined and Results Oriented in our pursuit to see every team member reach their personal, professional, and financial goals through the work we do together. Our core values are the backbone of our business and guide our hiring process: we are Transparent, Accountable, Aligned, and Inspirational.

OBJECTIVES

• Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt.
• Successfully works with payers via electronic/telephonic and/or fax communications.
• Responsible for verification and investigation of pre-certification, authorization, and referral requirements for services.
• Coordinates and supplies information to the review organization (payer) including medical information and/or letter of medical necessity for determination of benefits.
• Collaborates with designated clinical contacts regarding encounters that require escalation to peer-to-peer review.
• Communicates with patients, clinical partners, financial counselors, and others as necessary to facilitate authorization process.
• A/R follow/up and tracking
• Facilitates submission of clean claims and reduction in payer denials by adhering to both organizational and departmental policies and procedures and maintaining departmental productivity and quality goals.
• Appropriately prioritizes workload to ensure the most urgent cases are handled in a timely manner. Completes accurate documentation in both the Auth/Cert and Referral Shells.
• Completes notification to all payers via electronic/fax/telephonic means within 24 business hours of service to ensure compliance with Managed Care contractual requirements.
• Determines Medicare primacy based on Federal guidelines.
• Ensures timely and accurate insurance authorizations are in place prior to services being rendered.
• Answers provider, staff, and patient questions surrounding insurance authorization requirements.
• Charge entry and payment posting, reviewing claims and denials
• Perform medical records duties and all other duties as assigned
• Minimum of two years’ experience in outpatient billing/pre-authorization or insurance verification with demonstrated knowledge of health insurance plans including: Medicare, HMO's and PPOs required.
• Prior experience in a business office position with strong customer service background preferred. Education High School diploma

COMPETENCIES

The requirements listed below represent the knowledge, skill, and/or ability required to succeed in this role but are not necessarily all-inclusive.

• ICD-10: 2 years (Preferred)
• Medical Billers & Coders: CPT Codes and Clearing House Experience,

2 years (Required)

• Excellent verbal communication skills.
• Excellent interpersonal and customer service skills.
• Basic understanding of administrative and clerical procedures and systems.
• Proficient with Microsoft Office Suite or related software.

EDUCATION AND EXPERIENCE

• Associate (Preferred)

BENEFITS

• Paid Holidays
• PTO Program
• Simple IRA Matching after 1-Year of Service
• Free Chiropractic Treatment for Employee & Immediate Family
• Employee Discounts

COMMITMENT TO DIVERSITY

As an equal opportunity employer committed to meeting the needs of a multigenerational and multicultural workforce, Washington Care Clinic recognizes that a diverse staff, reflective of our community, is an integral and welcome part of a successful and ethical business. We hire local talent at all levels regardless of race, color, religion, age, national origin, gender, gender identity, sexual orientation or disability, and actively foster inclusion in all forms both within our company and across interactions with clients, candidates, and partners.

If this position caught your eye, send us your resume! For best consideration, include the job title and source where you found this position in the subject line of your email to sarah @washmocare.com a candidate? Please connect directly with your recruiter to discuss this opportunity.

Job Type: Full-time

Pay: $18.00 - $25.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Employee discount
• Health insurance
• Life insurance
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• ICD-10: 2 years (Preferred)

Ability to Commute:

• Washington, MO 63090 (Required)

Ability to Relocate:

• Washington, MO 63090: Relocate before starting work (Required)

Work Location: In person

Salary : $18 - $25