This position would be in office/person for the first 30-90 days and then would be a remote position.
GENERAL SUMMARY OF DUTIES:
Verifies and audits per tickets.
Checks for correctness and completeness prior to tickets being processed for billing, insurance filling and revenue reporting.
Monitors daily flow of fee tickets to ensure accuracy and timeliness of output.
Communicates to physicians when services are denied due to coding errors.
Responsible for verifying and updating demographic information on services performed outside of Clinic.
TYPICAL PHYSICAL DEMANDS:
Requires sitting/standing for long periods of time using a computer terminal and telephone.
Some bending and stretching required.
Occasional lifting up to 40 pounds.
Working under stress.
Requires manual dexterity sufficient to operate a keyboard, telephone, copier, fax and such other office equipment as necessary.
Vision must be correctable to 20/20 and hearing must be within normal ranges.
EXAMPLE OF DUTIES AND RESPONSIBILITIES:
To properly update patient demographic information for services rendered outside of the physician's office and verify correct insurance is entered into the Clinic Computer system promptly and accurately.
To review services rendered by physicians and determine:
A. If modifiers need to be added
B. If operative report should be attached to the claim
C. If correct coding of procedure for Medicare Patients properly represents a payable diagnosis based on Medicare Medical Policy and if it does not, to communicate this discrepancy to the physicians.
To ensure all services rendered by Elkhart Clinic Physicians are entered into our billing system in a timely and accurate fashion and if none received, to follow up with the physician in a timely manner.
To follow up with the Collections Department and communicate with them services entered into Clinic Computer System for patients who have health insurance coverage.
Perform other duties as assigned.
KNOWLEDGE, SKILLS, ABILITIES:
Working knowledge of Insurance claims process including CPT and ICD-10 coding.
Telephone etiquette.
General understanding of insurance processing and policies, which govern these plans.
Ability to operate computer, ten key adding machine, various printers, forms, and telephones.
Ability to type 35 wpm. Ability to maintain confidentiality.
Ability to be a team player.
EDUCATION:
High School diploma or GED
EXPERIENCE:
Experience in coding practices, including one-year medical coding experience or equivalent training.