Senior Biller/Coder

3 hours ago


San Jose, United States Wellness Equity Alliance Full time
Wellness Equity Alliance (WEA) is a novel national public health organization comprised of a multidisciplinary team of population and public health experts with backgrounds in infectious disease, public health, emergency medicine, primary care, cardiology, pediatrics, psychiatry, community health work (CHW), nursing and advanced practice pharmacy. We work nearly exclusively with underrepresented communities, fundamentally addressing health-care disparities and the social determinants of health (SDoH) that have been amplified during the COVID-19 pandemic, prioritizing the following:
  • People experiencing homelessness
  • Indigenous communities
  • Immigrant communities
  • Rural communities
  • BIPoC communities
  • LGBTQIA+ communities
  • Justice-impacted communities

The WEA team is diverse, inclusive, and nimble enough to assemble teams of healthcare professionals within days using our proven local staff recruitment models to address population health crises and communicable disease outbreaks. The WEA team's partnership model is collaborative and allows hospitals, health jurisdictions, state/local government agencies to provide timely care using equity-based strategies for individuals and marginalized communities.

Summary:

The Biller/Coder is responsible for accurately coding medical records and processing claims for multiple healthcare locations. This role requires meticulous attention to detail, deep knowledge of coding standards and insurance guidelines, and the ability to work collaboratively with various departments to ensure timely and accurate billing.

Key Responsibilities:

1. Medical Coding:

o Review and analyze medical records to determine appropriate coding (CPT, ICD-10, HCPCS).

o Ensure coding compliance with federal, state, and payer-specific regulations and guidelines.

o Stay updated with changes in coding standards and guidelines.

2. Claims Processing:

o Prepare and submit clean claims to insurance companies, Medicare, and Medicaid.

o Identify and resolve billing errors or discrepancies to ensure accurate and timely submission.

o Monitor claim status and follow up on unpaid or denied claims.

3. Billing and Revenue Cycle Management:

o Verify patient insurance information and eligibility.

o Coordinate with front-desk and administrative staff to gather missing patient or billing data.

o Reconcile accounts receivable and assist in resolving any billing issues.

o Communicate with patients regarding billing inquiries and provide assistance as needed.

4. Compliance and Documentation:

o Maintain accurate, detailed documentation of billing activities.

o Comply with HIPAA and other privacy regulations.

o Assist in audits and reviews of billing records.

5. Collaboration and Training:

o Work closely with clinical and administrative staff to ensure accurate documentation and coding.

o Provide guidance or training on coding best practices as needed.

Requirements

Education: Certification in medical coding (CPC, CCS, or equivalent) required; bachelors degree or higher in a related field preferred.
  • Experience: Minimum of 3-5 years of experience in medical billing and coding, preferably in a multi-location healthcare environment.
  • Technical Skills:
    • Proficient in healthcare billing software and electronic medical records (EMR) systems.
    • Strong knowledge of CPT, ICD-10, HCPCS, and insurance policies.
  • Soft Skills:
    • Excellent attention to detail and analytical skills.
    • Strong communication and interpersonal skills.
    • Ability to work independently and collaboratively in a fast-paced setting.

Work Environment:
  • Ability to travel between healthcare locations as required.
  • Flexible working arrangements may be available based on organizational needs.

Salary Description

$30/hourLearn More

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