Job Description

Billing and Coding Specialist



• Summary: •

The Billing and Coding Specialist will ensure health providers are paid for medical services rendered. Responsible for the accurate flow of medical information and patient data between physicians, patients, and third-party payers and billing companies. Sorts and files paperwork, handles insurance claim queries, and performs collections duties as needed.

•Duties and Responsibilities: •

Translate patient information and medical procedures into alphanumeric medical code that can be translated by payers, other medical coders, and other medical facilities

Collect, post, and manage patient account payments

Validate patient statements

Perform follow-up on all rejected and denied claims, ensuring timely correction and resubmission alongside outsourced team

Monitor accounts receivables activity

Respond to and resolve patient and insurance provider inquiries and complaints related to billing, claims, and collections

Communicate effectively with the revenue cycle team and other departments to address and escalate issues

Funds confirmation

Maintain strict confidentiality

Code patient services and enter into computer

Sort and file paperwork

Coordinate billing and collection activities

Serve as the subject matter expert on coding, billing, and collections processes

Subject matter expert on Holds and stops

•Experience: •

High school Diploma or GED required

Associates degree preferred

Knowledge of the basics of medicine, such as: anatomy, physiology, disease, and diagnoses is required

Knowledge of business operations, insurance claims processes, basic office procedures and the use and application of medical billing software required

5 + years of experience in billing and coding

2+ years' experience with DME preferred

Develops strategic plans and programs for the Revenue Cycle team and ensures that the goals and objectives of the team are properly defined and clearly established.

Directs and oversees revenue cycle management (RCM) functions by providing leadership, organizational, and strategic direction to drive efficient, accurate, and compliant RCM billing activities to maximize reimbursement.

Heads the billing function: reviews billing activities; directs the authorization, billing, and collections staff: and assures the business maximizes its revenue potential.

Develop and implement programs, projects, strategies, processes, and technology to continuously improve and manage the revenue cycle and increase profitability.

Resolve and reconcile submissions, rejections, and edits on a daily basis.

Monitor and communicate ever-changing insurance carrier rules and regulations

Enter charges, post patient deposits, and quality assurance of entries and submissions

Compiles and prepares various status reports for management in order to analyze trends and make recommendations.

Enhance and standardize work-flow processes throughout the revenue cycle to assist in achieving consistency in maintaining the critical success factors outlined in the company's standard operating procedures.

Create a cross-functional training manual for leaders that incorporates, as well as, aligns the Company's strategy and culture of Certainty and Operational Excellence.

Job Type: Full-time

Pay: ?8,919.93 - ?46,143.31 per month

Schedule:

• Night shift

Experience:

• total work: 2 years (Required)
• Medical Coding: 1 year (Preferred)

Work Location: In person