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Medical Biller and Coder

3 months ago

Napa, United States HCMS Napa LLC Full time
Job DescriptionJob Description

Job Description

The Remote Billing and Coding Specialist works directly with the Revenue Cycle Director to ensure the coding and abstracting of documentation are conducted in an accurate, comprehensive, and efficient manner. The Remote Billing and Specialist must be experienced in all aspects of both diagnostic and procedural medical coding and billing, surgical coding experience preferred.

Experience:

  • Medical Billing: 2+ years (preferred)
  • Coding Certification (CPC) 2+ years (required)
  • Understanding of Revenue Cycle operations including; charge capture, health information management, billing, collection, denials, and bad debt.
  • Working knowledge of CPT, HCPC, ICD-9/ICD-10 codes, CMS 1500 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits, and the appeal process.
  • Software knowledge required: Microsoft Windows, and Microsoft Office (Word & Excel), and some form of medical billing software
  • Detail-oriented and tolerant of frequent interruptions and distractions from multiple sources.
  • Excellent mathematical, written, and verbal communication skills

Benefits offered:

  • Generous Paid time off
  • Retirement plan
  • Great work environment with a supportive & enthusiastic team
  • Opportunities for growth in your career

ESSENTIAL JOB FUNCTIONS

  • Assists team in the operations of the billing department, encompassing coding, charge entry, and claims submissions.
  • Assists with analyzing billing and claims for accuracy and completeness: submits claims to proper insurance entities and follows up and resolves any claim submittal issues.
  • Understands and remains updated with current coding and billing regulations and compliance requirements.
  • Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
  • Follows billing guidelines and follows established policies and procedures..
  • Maintains confidentiality of patient and client-related business.
  • Develops and maintains an effective working relationship with team members, clients & staff, and patients
  • Abstract information from medical record/op notes and assign appropriate codes, as necessary.
  • Prepare and submit claims to third-party insurance carriers either electronically or by hard copy billing.
  • Post charges, payments, and adjustments.
  • Understand insurance benefits including copays, deductibles, and coinsurance.
  • Interacts with internal providers and external facilities to procure documentation for coding claims, as necessary.
  • Research rejected and denied claims.
  • Understand and apply medical terminology, ICD-10, CPT-4, & HCPCS coding guidelines & payer rules.
  • Work with physicians and others to ensure complete and accurate information and optimal reimbursement based on coding.
  • Read, interpret, and enter information into the facility's database using medical coding protocol to produce a statement or claim.
  • Conduct various audits and data reports for supervisor.
  • Performs other related duties as assigned.