POSITION SUMMARY:
The Medical Billing & Coding Specialist is responsible for reviewing daily patient account transactions with a high level of speed and accuracy. Assists with the collection of insured accounts and maintenance of documents. Posts payments to transactions to patient accounts accurately.
DUTIES AND RESPONSIBILITIES:
- Performs insurance/patient payment posting and resolves payment transaction discrepancies with assistance from the Lead/Supervisor/Manager when necessary.
- Working knowledge of ICD-10, CPT, and HCPCS to review chart notes and ensure appropriate codes are assigned to all claims regarding diagnosis and procedures for provider services performed.
- Working knowledge of payer websites and practice management systems with the ability to recognize and resolve front/back end claim denials from assigned payers and all others as determined necessary by the Billing Supervisor/Manager, utilizing collection procedures and adjusting of patient accounts when necessary.
- Answer patient questions regarding statements in person and through phone calls.
- Knowledge of appropriate third-party liability (TPL) and government websites (i.e. CHAMPS, C-SNAP, WebDenis, HMO Medicaid websites preferred, and working knowledge of ICD-10, CPT, and HCPCS.
- Ability to use Microsoft Office, Internet, practice management system and relational database system software.
- Ability to work effectively and efficiently under tight deadlines, high volumes and multiple interruptions.
- Attends all departmental and organizational meetings as required.
TYPICAL WORKING CONDITIONS:
- The noise level in the work environment is usually quiet to moderate.
TYPICAL PHYSICAL DEMANDS:
- While performing the duties of this job, the employee is regularly required to use hands for use of a PC as well as other office equipment.
- The employee is frequently required to stand; walk; sit and talk and use hearing to listen. The employee is occasionally required to reach with hands and arms and stoop, and kneel.
- The employee must occasionally lift and/or move up to 25 pounds.
- Specific vision abilities required by this job include close vision, color vision and ability to adjust focus.
QUALIFICATIONS:
- Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
- To perform this job successfully, an individual should have working knowledge of Microsoft Office utilizing Excel Spreadsheet software and Word processing software. Ability to use Internet, practice management system and relational database system software. Must have the ability to learn additional software to support the Accounting/Finance function.
- Ability to work effectively and efficiently under tight deadlines, high volumes and multiple interruptions.
EDUCATION/EXPERIENCE/CERTIFICATIONS/LICENSES:
- Must have a minimum of a high school diploma
- Prefer an Associate Degree in Business with emphasis in Accounting/Finance from an accredited college or university in addition to one year of experience or equivalent combination of education and experience.
- 1-2 years accounts receivable billing experience required. Areas of Family Medicine/internal medicine, preferred. PT/OT, and Behavioral Health a plus.
- Prefer knowledge of EPIC system; must have appropriate third party liability (TPL) and government website knowledge (i.e. CHAMPS, C-SNAP, WebDenis, HMO Medicaid plans).
- Working knowledge of ICD-10, HCPCS, and CPT.
