Job Description
A certified professional biller/coder (CPC)
Salary 15-25 base on expertise and experience
Responsibilities:
Overseeing the medical coding for all healthcare activities
Ensure that medical coding used is in compliance with all medical coding laws and regulations
Ensure that the coding used is for reimbursable expenses when necessary
Provide regular coding, Home Health coding, or hospital coding as appropriate
Communicating with patients regarding rejected claims or procedures
Interact with doctors, nurses, and office staff
Able to work during regular business hours and rarely work overtime or weekends as necessary
Responsible for entering charges in as accurate a manner as possible, which means coordinating with the doctors office to obtain any missing information (i.e., insurance cards, authorizations, op reports, etc.) Knowledge of correct CPT coding and ICD10 coding
CPR bills all types of insurance such as Medicare, Medicaid, HMOs, PPOs, Cigna, Aetna, Humana, Blue Cross Blue Shield etc.
Posting Payments
o Post all payments to the patients computer record
o Record deposit amounts in an Excel spreadsheet
o Also includes following up on all denied claims, pended claims, returned mail, etc.
o Involve writing letters to insurance companies for appeal or regarding disputed issues
Collections: Responsible for collecting all payments on the account to the best of your abilities. An aged Accounts Receivable is generated for doctors account on a monthly basis. Billing representatives are responsible for making sure all accounts aged over 40 days are extensively researched to prevent any further delay in payment. This includes calling insurance companies and patients, initiating payments agreements, etc.
Office Interfacing: Billing representative is required to interface with the doctors office in an organized and professional manner to obtain all information necessary and give guidance as needed regarding reimbursement issues. On a monthly basis (minimum) the billing representatives are often required to meet with the physician, as well as his/her staff, to resolve policy issues and discuss billing matters and collections issues. Communication with doctors office regarding current insurance contracts, and other change
Month End Reporting: Accounting summary reports are generated on a monthly basis using Excel. Reports need to balance other accounting records and need to be reviewed by billing representative for accuracy. Reporting of changes in the doctors charge patterns or income are to be discussed with management on a monthly basis.
Competences:
Actual certification for medical coding
Expertise in a variety of insurance and medical coding regulations
Associates degree in health administration and RHIT certification
Preferred CPC or CCS-P
Excellent letter writing skills
Knowledge of
o CPT and ICD10 coding
o Medical terminology
Detail and critical thinking skills
Excellent communication skills
Excellent interpersonal skills
Strong knowledge in computer programs
o Microsoft Office
o E Clinical Works 11 version
Be Prepared As Follows:
References: (Required) minimum of one (5) year experience in your field.
Employment Eligibility Documents (e.g. Permanent Resident Card, Passport see list at: www.uscis.gov/i-9-central/acceptable-documents )
Company Descriptionhttps://www.denniscortesmd.com/index.html