Description:
We are looking for a Certified Billing and Coding Specialist to review and enter claims to ensure the assigned procedural and diagnosis codes meet required legal and standardized insurance rules for an orthopedic spine practice.
Job function:
• Validates charges and documentation to ensure billing codes are accurate prior to claims submission. Seeks clarification from provider and/or clinical staff as needed.
• Applies coding (CPT, HCPCS, and ICD-10) and modifiers accurately and appropriately.
• Applies payer specific coding requirements as appropriate.
• Codes for all services performed. Services may include office visits, in-office injections, in-patient and outpatient procedures in the hospital, and procedures in an ambulatory surgical center.
• Assists with prior authorization coding and accounts receivable coding denial reviews.
• Adds account notes when a claim has been changed or reviewed.
• Daily review of claims prior to claims submission.
• Provides feedback if there are trends in coding errors.
• Participates in continuing education programs to increase coding knowledge. • Assisting with surgical scheduler on proper procedure codes
Qualifications
• High school diploma or GED required
• Coding certification through AAPC or AHIMA required. CPC preferred
• At least three years of experience in medical coding required and two years of experience with orthopedic spine
• Knowledge of medical terminology and coding, including, ICD-10, CPT and HCPCS required. OB/GYN specific knowledge preferred
• Experience in Athena is preferred
• Demonstrated ability to be detail oriented with strong aptitude for accuracy required
• Demonstrated ability to effectively work with others required
• Knowledge of local and major national medical insurance practices preferred
• Knowledge of proper business writing standards for letters and memos including the ability to write a correspondence with proper punctuation, grammar, spelling, etc
• Proven effective verbal, listening and written communications skills Benefits
• Competitive compensation
• Health, vision and dental benefits
• Ability to contribute to non-match 401(k)
• Accrue Paid time off
• Holiday pay