Coder
Our office is in need of a well‑experienced coder who knows how to read, look and identify modifiers on diagnosis or ICD‑9 codes and CPT‑4 codes procedures used by providers and insurance companies. Both diagnosis and procedure codes are used on HCFA‑1500 Form to bill claims for health care providers.
Duties and responsibilities
Review and check claims (claim or superbill) for errors on diagnosis and procedure codes, identifying modifiers on ICD‑9 and CPT‑4 codes used by providers and insurers.
Gather data, information and updates and inform health‑care providers of changes to diagnosis or procedure codes.
Check codes to avoid down‑coding and maximize reimbursement.
Speak on the phone with life‑insurance applicants to obtain health and applicant information.
Data entry, monitor online orders, take orders from agents and schedule paramedical services.
Schedule and make appointments for pre‑set paramedical examinations, confirm bar code, track case‑work sheets and review lab slip reports.
Designate case or work‑order assignment to phlebotomist/field examiner and monitor progress of the assigned task for completion.
Qualifications
Medical degree or coder certificate or equivalent.
At least 1 year of experience in medical and dental coding procedures.
Knowledge of processing insurance claims on paper and electronic claims, and strategies for reimbursement and collections follow‑up.
Knowledge of medical and dental benefits across insurance carriers and government health agencies.
Proficient in computers and software applications such as Medisoft, AltaVista, Dr. Leonard, or other medical billing software.
Proficient and have good communication skills, tact, and dependability.
Ability to meet the duties and responsibilities with excellence and a high level of expectation.
Valid driver’s license and reliable transportation for pick‑up of charge slips and superbills at providers’ offices or clinics.
Willing to work full‑time, part‑time or on‑call, and may be required to work weekdays and holidays as necessary.
Positive attitude, good human interaction, and willingness to accept new challenges and complete tasks promptly.
Typing speed of at least 35–45 wpm and knowledge of MS Office suite.
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