The Hand Center

Job Summary: Performs medical coding and various revenue cycle tasks at the direction of the Billing Manager/Practice Administrator including, but not limited, to entering charges into the practice management system, following up with payers on outstanding balances, posting payments to accounts, submitting secondary and tertiary claims, answering patient billing questions and working task queues to maximize the receipt of appropriate revenue for the services provided.
Essential Functions:
  • Uses CPT manual and ICD-10 manual to code from operative reports and other medical records
  • Reviews CCI edits
  • Enters physician and therapy charges into the practice management system
  • Reviews and corrects denied claims for assigned payers daily including any required  contact with payer or patient and other staff members to verify/obtain insurance information, coding and demographic information.
  • Follows up with payers to ensure payment of outstanding claims.
  • Coordinates and prepares explanation of benefits for submission to secondary and tertiary payers for payment.
  • Prepares and submits appeals on denied claims.
  • Performs follow-up on aging accounts using a current aging or other receivables report(s).
  • Answers the telephone, works with patients, insurance companies and other third-party payers to resolve billing issues.
  • Maintains clearly marked and dated tickler files of outstanding work.
  • Performs other functions within the billing department related to patient statements, transmission of claims, report generation, etc.
  • Maintains CEU’s and CPC certification
  • Works on departmental projects as assigned by supervisor.
  • Complies with all HIPAA regulations.
  • Any Other duties as assigned.
Qualifications:
  • Minimum of high school diploma with additional technical training in medical coding 
  • Minimum 6 months-one year experience in coding or general Billing and A/R work.  Preferably in an Orthopedic office setting 
  • Excellent knowledge of CCI edits and CPT modifiers
  • CPC or CPC-A Certification