Medical Billing/coding Specialist - Wilmington, United States - Rheumatology & Internal Medicine

Description

Job Summary

Under the general supervision of the Physician/Manager provide daily operations of patient billing including accurate claims submission, accounts receivable follow-up, payment posting, EOB and COB processing, credit balance refunds, bad debt, collections, and patient estimates for healthcare visits.

Medical billing staff members are responsible for training, coaching, helping, and sharing knowledge with all staff to help ensure the practice meets its financial and operational goals and objectives.

Position Description

DUTIES AND RESPONSIBILITIES:

• Under the general supervision of the Physician/Manager provide daily operations of patient billing including accurate claims submission, accounts receivable followup, payment posting, EOB and COB processing, credit balance refunds, bad debt, collections, price estimates for healthcare visits, and other activities related to billing. Please note this is a working supervisor position, onsite.
• Provide education and support to ensure that patient billing effectively and efficiently meets the financial and operational goals and objectives of the practice.

- work on projects that will enhance or support the billing processes for overall effectiveness and helps staff reduce the number of days in accounts, days in A/R, denial rates, and uncollected patient balances.

• Coordinates the daily activities in the department, ensuring that they are executed in a timely manner and in accordance with organizational/departmental/thirdparty payers' payment policies.
• Coaches staff to understand thirdparty payers' billing and coding rules to detect potential claim errors, as well as systems' functionality.
• Coordinates phone line coverage schedule and covers the phone lines. Oversees incoming calls to ensure excellent customer service and handles incoming calls on patient billing which other staff cannot resolve.
• Keeps the Manager/Physician updated on all operational issues that arise and involves the Manager/Physician when clarification is needed. With direction, resolves most problems and/or recommends solutions to operational/practice billing and coding issues.
• Keeps the Manager/Physician informed of billing activities progress and assists the Manager/Physician in ensuring the practice meets the financial and operational objectives of the practice.
• Runs and analyzes reports and provides feedback and recommendations to the Manager/Physician.
• Assists the Manager/Physician to ensure continuity of systems and implements new workflows, operational policies, and procedures in the billing department.
• Assists the Manager/Physician in communicating with departments, billing vendor, and thirdparty payers to ensure patient billing effectiveness and efficiency.
• Assists the Manager/Physician in interviewing and hiring new billing staff and provides training and coaching to new billing staff.
• Performs all job functions in compliance with applicable federal, state, local, and organizational policies, and procedures.
• Works on special projects as needed.

COMPLIANCE:

• Adheres to the expectations and professional responsibilities of the practice.
• Employs the standards, practices, and procedures of the practice, government and state regulations, third party payor compliance.
• Completes and complies with practice training requirements including HIPAA Privacy and Security.
• Reports noncompliance incidents to the supervisor, manager, and/or Compliance Officer.

1.
Basic Qualifications
High school graduate or equivalent and 7 years' medical billing experience, Certification in coding.

Solid knowledge of CPT, ICD-10, and HCPCS coding, billing systems (Allscripts preferred) and other EHR software, and intermediate level knowledge of MS Excel and Word.

Ability to interpret, explain, and implement third-party payer and Medicare billing policies.


Licensure, Certification, Registration:

CPC (Certified Professional Coder through American Academy of Professional Coders) or CCS-P (Certified Coding Specialist Physician based through American Health Information Management Association) is required.

Additional Qualifications and Skills

Time Status
Full-time-Onsite only


Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work Location:
In person