Medical Billing and Coding Specialist

Education, Experience, and Licensing Requirements:

• High school diploma, GED, or equivalent
• University/college degree, or experience medical records, claims or billing areas is an asset.
• CCA (AHIMA) CCS (AAPC) or greater

Expectations of Role:

• Manages the Insurance billing and collections processes.
• Excellent organizational skills and attention to detail. .
• Processes, tracks claims, and ensures accuracy and timeliness in the billing process.
• Provides excellent customer service to our clients.
• Inputs patient information into the practice’s billing software.
• Submits claims to insurance companies and follows up on unpaid claims.
  
  
• Posts ERA payments, Resolves any issues that arise with claims or payments.
  
• Maintains accurate records of billing and collection activities
• Generates monthly reports to track billing and collection performance.
• Accounts for coding and abstracting of patient encounters, including procedural information, significant reportable elements, and complications.
• Researches and analyzes data needs for reimbursement.
• Analyzes medical records and identifies documentation deficiencies.
• Serves as resource and subject matter expert to other coding staff.
• Reviews and verifies documentation supporting diagnoses, procedures, and treatment results.
• Identifies diagnostic and procedural information.
• Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
• Assigns codes for reimbursements, research, and compliance with regulatory requirements utilizing guidelines.
• Follows coding conventions. Serves as a coding consultant to care providers.
• Identifies discrepancies, potential quality of care, and billing issues.
• Researches, analyzes, recommends, and facilitates a plan of action to correct discrepancies and prevent future coding errors.
• Identifies reportable elements, complications, and other procedures.
• Serves as resource and subject matter expert to other coding staff.
• Assists lead or supervisor in orienting training, and mentoring staff.
• Provides ongoing training to staff as needed.
• Handles special projects as requested.
• Proficient in Excel sorting, pivots, and VLOOKUP
• This is not a Remote Postion.