Medical Billing/ Coding Specialist


Job Description


Job Timings: 09:30 PM-05:30 AM

 

Responsibilities:

-Monitor Insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner- knowledge of questions to ask for proper processing.

 

-Working knowledge of CPT and ICD-9 and 10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits, and appeal process.

 

-Ability to stay aware of billing/submission delay issues (encounters not closed/items not being billed/more accurate coding to use for increased revenue)

 

-Ability to learn all office programs and foster relationships with vendors in order to provide timely daily/weekly/monthly/quarterly/yearly reports as requested/needed

 

-Work with providers to correct the diagnosis or procedure codes so that the claim can be processed.

 

-Respond to and process insurance claim disputes.

 

-Knowledge of electronic billing systems 

 

-Coordinate insurance reimbursement of care providers

 

-Ability to work with staff to assist with referral/auths needed to ensure payment of procedures

 

-Researches and processes refund requests and overpayments.

 

-Generates and submits electronic claims and corrects any errors for complete and accurate transmission of data.

 

-Knowledge of medical terminology.

 

-Use of online reference data base services.

 

-Attention to detail, able to prioritize workload.

 

-Strong organizational and planning skills.

 

-Excellent written and verbal communications skills.

 

-Proficiency in MS Office and Patient Management software.

 

Preferred Experience:

 

-Revenue Cycle Management (RCM) Experience 

-Certified Professional Coder (CPC)

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