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.