Medical Billing and Coding Specialist

*Required to work on-site in Manhattan, KS*

Position Summary: The Medical Billing and Coding Specialist processes insurance claims, invoices and payments ensuring medical information and patient data is accurately communicated between patients, physicians, and third-party payers. They use medical coding protocols to create claims or statements.

Essential Functions:

• Transcribe patient information into medical codes and ensures the accuracy of the codes and medical reports
• Prepare and submit claims for payment, follow up on unpaid claims and correct rejected claims
• Prepare and send invoices for remaining balances
• Track outstanding payments and follow up with patients and insurance companies about outstanding bills.
• Communicate with medical providers, insurance companies and patients
• Verifies insurance coverage and eligibility and communicates with insurance companies.
• Correct rejected claims and re-submit as needed.
• Assists patients with billing concerns and follow up with patients about outstanding bills.
• Work with patients to create payment plans when needed.
• Review documents from providers for missing information, typos and grammatical or coding errors.
• Conduct chart audits and verify chart and coding discrepancies.

Secondary Functions:

• Provides customer service at the clinic and the health department.
• Perform other duties as assigned.

Position Requirements:

Education: Highschool diploma or equivalent required. Associate degree preferred with general office experience, or equivalent combination of education and experience.

License(s)/Certification(s): certification from the American Academy of Professional Coders or similar certificate preferred.

Experience: 2 years’ experience as a medical billing and coding specialist required. Knowledge of a body of standardized rules, procedures or operations. Knowledge of medical billing codes such as CPT, ICD-10 and HCPCS. Knowledge of medical terminology Experience in working with the public.

Skills: Basic math skills required. Word processing applications including Microsoft Word and Excel.

Supervisory Control: Work is assigned under guidelines by the supervisor and performed independently on own initiative. Deadlines, issues and policies are reviewed with supervisor.

Guidelines: Guidelines are written and oral. Employee follows guidelines set by state, federal and local statute, and Riley County policy and procedure.

Complexity: Varied complex duties must be performed with accuracy and continual deadlines.

Scope and Effect of Work: Work must be accurate as and performed with a high level of integrity. The position contributes to the overall smooth function of the Health Department and Riley County’s responsibility to the taxpayer.

Personal Contacts: Public, co-workers, local officials, coworkers, auditors, and finance officers.

Purpose of Contacts: The purpose of contacts is to obtain, clarify, give, or screen established factual information, regardless of the type (i.e., easily understood or technical). Normal communication skills are required. Ability to defuse high pressure situations is critical.

Physical Demands: The physical demands described represent those required to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms. The employee must regularly lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.

Work Environment: The work environment characteristics represent those encountered while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee exposed to a normal noise level.

The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if work is similar, related or a logical assignment of the position.

The job description does not constitute an employment agreement between the employer and the employee and is subject to change by the employer as the needs of the employer and requirements of the job change.