Description
Scope of Tasks & Responsibilities:
- Analyze patient charts carefully to know the diagnosis and represent every item with specific codes.
- Collect health information as documented by medial provides and code appropriately. Consult with providers for further classification of items on patient charts to avoid misinterpretations.
- Maintain certification by staying up to date on new coding rules and regulations.
- Conduct audits of patient charts to verify appropriate coding was applied and review with physicians for training purposes.
- Review of patient medical charts to identify proper coding for denied claims.
- Collect and distribute coding related information and billing issues.
- Handle claims denial follow-up.
- Perform billing functions as it pertains to coding.
- Assist Clinic staff with patient coding and related procedures
- Collaborate with supervisor to increase revenue and system efficiency
- Communicate all outstanding billing required from Providers on a timely basis.
- Maintain confidentiality in accordance with RHC policy, HIPAA and any other applicable regulatory requirements.
- Exemplify the RHC mission through a personal example of excellent service to patients, visitors and coworkers.
- Attend regularly scheduled staff meetings
- Other duties as assigned
Requirements
Required Education, Certification, Experience and Skill:
- Business school training in medical billing preferred or comparable two years
- Current CPC or HCPCS Certification. ICD-10 certification a plus
- Have demonstrated knowledge/experience with medical terminology, claims processing, and medical coding.
- Have a thorough understanding of managed care concepts including HMO, MCE and capitation
- Have a solid understanding of Medicaid and Medicare.
- Have a solid understanding of the complete billing cycle.
- Dental billing experience a plus.
- Optometry billing experience a plus.
- Proficient with MS Office and Practice Management Systems [ECW preferred].
- Strong interpersonal and communication skills with an ability to work effectively with a wide range of people, supervisors, co-workers and vendors.
- Exceptional customer service skills
- Bilingual in Spanish a plus.