You will be responsible for a variety of tasks requiring data analysis, in-depth evaluation, and sound judgment. As our medical biller, your daily duties will include maintaining billing software, appealing denied claims, and recording late payments.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily, these include but are not limited to the following. Other functions may be assigned, and management retains the right to add or change the duties at any time. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Knowledge of coding regulations, CPT, ICD-10-CM, and HCPCS
CCI edits, LMRP, computer knowledge (Windows Based), and must be able to communicate written and orally with physicians
The ability to work independently as well as on a team
Excellent organization and problem-solving skills and the ability to change and be flexible with work priorities
Strong attention to detail
Obtain, review, and input insurance authorizations and referrals prior to patient services
Ensure all claims are submitted
Verify completeness and accuracy of all claims prior to submission
Coordinate referral appointments
Monitor and track patient authorizations
Respond to inquiries from insurance providers and patients
Data entry of patient demographics
Ability to appropriately assign modifiers
Follow up on late or missed payment notices
Researching each diagnosis for test ordered by physician
SKILLS & ABILITIES
Education and Experience: Bachelor’s degree in business, health care administration, accounting, or relevant field. A minimum of 2 years’ experience as a medical biller or similar role.
Computer Skills: Basic phone, computer, electron skills (email, Microsoft Word, Microsoft Excel, Internet, Fax, Copier, etc.) Solid understanding of billing software and electronic medical records.
Certifications and/or Licenses: Certification of coding will be required within 1 year, which includes RHIA, RHIT, CCA, CCS, CPC, COC, CIC, CPC-P, CEMC, CEDC
Assigns codes for diagnosis, modifiers, and/or CPT codes to designated accounts and maintaining 90% quality standards.
Codes/enters charts within an appropriate number of charts per hour.
Coordinates completion of the A/R report and/or is compliant with late charges.
Remain informed about coding issues to comply with federal regulations.
Responds promptly to internal and external customer coding requests. Responds promptly to Business Office requests to code or review coded accounts for accuracy. Works closely with other departments to ensure all data captured is accurate (ie Provider Clinics or Outpatient Registration).
Team-oriented with strong interpersonal skills. Will help cover other areas as assigned.
Ability to code or charge entry ancillary designated charge entry clinics.
Assumes all other duties and responsibilities as necessary.
Strong interpersonal skills
Excellent communication and listening skills
Strong ability to manage time and prioritize tasks
Knowledge of state and federal statuses regarding patient confidentiality laws
Possess knowledge of billing software
General knowledge of ICD-9, ICD-10, and CPT codes
Prolonged sitting at a desk and working on a computer
Frequent use of fine motor skills to handle or feel objects, tools, or controls and ability to reach with hands and arms on a regular basis
Intermittently required to lift objects weighing up to 20 pounds
Consistently required to talk, hear, and/or speak
Specific vision abilities required by this job include close vision and the ability to adjust focus along with the ability to read, analyze, and interpret procedures and/or instructions
Some assignments may require ability to have or arrange for dependable means of transportation to other clinic locations, meetings, or community events
Work is performed primarily in office, individual owned and insured vehicles, and outdoor settings, in all weather conditions, including temperature extremes, during day and night shifts. Work is often performed in emergency and stressful situations. The noise level in the work environment is usually quiet in office settings and moderate in other situations.