Job Details
Description
Summary
To use a knowledge of medical records coding rules, insurance and Federal, State and Municipal regulations and reimbursement rules. To have the ability to communicate clearly with personnel, patients, clients and insurance companies. To maintain and update coding and billing certification requirements
Essential Duties and Responsibilities
These duties and responsibilities described below represent the general tasks performed on a daily basis. Any other duties as needed to drive to the vision fulfill the mission and abide by the values of the organization.
Attend required hospital-wide orientations, meetings, and in-services
Demonstrate a commitment to flexible work scheduling when necessary to ensure patient care
Develop and/or update master file of procedure and diagnosis codes
Update organization fee schedules as necessary
Work with other members of the billing and reimbursement staff in identifying and correcting insurance claims
Assign proper CPT and ICD-10 codes from the patient medical records for proper claims submission
Process patient Accounts Receivable, insurance carrier Explanation of Benefits (EOB), denials and documentation requests as needed
Post insurance and patient payments including any pertinent correspondence into the computer system
Perform internal audits of billing and reimbursement procedures
Perform internal chart audits for billing and coding accuracy
Coordinate and cooperate with internal and/or external auditors during billing and organization audits
Comply with all rules, regulations and procedures of the organization
Process patient and insurance carrier telephone calls for account inquiries
Perform any other job duties assigned by the Billing Department Manager or other Managerial Staff
Supervisory Responsibilities
Reports to:
Billing Manager
Supervises:
n/a
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience
Minimum Required Education:
Certified Professional Coder Certificate
Preferred Education:
Associates Degree in Healthcare
Experience:
Previous healthcare billing, coding and follow-up experience, ability to operate copier, FAX machine and computer, must have excellent organizational, communication and interpersonal skills, must have the ability to set priorities and manage varying workload
Certificates, Licenses, Registrations
Certified Professional Coder Certificate required
Qualifications
Education
Required
High School or better.
Experience
Preferred
1 year:
Previous healthcare billing, coding and follow-up experience
Licenses & Certifications
Required
Certified Professional Co
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
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