Billing and Coding Specialist

This non-exempt Billing & Coding Specialist position will interact with insurance companies and with patients to ensure accurate, streamlined coding/ billing and payment posting. This position is responsible for job duties such as:  translating patient conditions and provider’s medical treatments into universal medical codes for translation by various parties, creation and submission of claims as well as assist in internal auditing of all billing and coding activities to ensure consistency, accuracy and completeness.

Essential Duties, Functions & Responsibilities

·         Reviewing medical procedures/Progress notes as documented by providers & resources

·         Translating medical procedures into codes that can be translated by payers, other medical coders, and other medical facilities

·         Transmitting coded patient treatment information to payers and other recipients

·         Coordinating insurance reimbursement of care providers

·         Handling patient billing, accounts receivable from payers

·         Addressing A/R aging report

·         Establish payment plans with patients

·         Assist in positing payments from all methods, assist in reconciliation

·         Ensure coding practices are within American Medical Association CPT/HCPCS guidelines

·         Diligent review EBO’s, address rejections, requests, denials pursuant to AVS billing policy

·         Audit internal posting, coding, and billing activities

·         Review new patient insurance to ensure accuracy

·         Post payments- ERA, checks, credit cards, cash payments

·         Review all denials for correction, execute corrections

·         Review VA authorization to ensure planned care coincides with authorization

·         Upload or fax medical records to appropriate payer/institution as required

·         Assist in transmitting all claims to clearinghouse

·         Serve as a point of contact for all billing questions stemming from providers, patients and office staff

·         Bill paper claim to insurances that  do not accept electronic format

·         Consistently follow-up with outstanding claims to deduce timely payment from payer

·         Work cohesively with other members of Coding/Billing team as well as other members of staff

Qualifications & Experience

·         High School Diploma or Equivalent 

·         Candidate or possession of a Professional Coder Certificate (CPC) from APPC

·         Familiarity of Vascular Anatomy/Coding/Procedures

·         Minimum 3-5 years’ experience of patient care

·         Superior communication & organizational skills