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Coding Specialist

2 months ago

Concord, United States Balance Health Full time
Job DescriptionJob DescriptionDescription:

Under supervision of the RCM Billing & Coding Manager serve as a Coding Specialist (coder), responsible for reviewing claims activity for proper coding in the revenue cycle billing and claims functions. This position may be required to travel to the practices within the Balance Health Network. This is a remote position but the person in this role will be required to work 7:30am-4:00pm PST, preferably someone in the pacific time zone.


Duties and Responsibilities

  • Responsible for billing, coding, and resolving encounter forms from the clinics, surgery centers, and hospitals related to Balance Health
  • Identify and present improvement recommendations based on gathered knowledge and experience while working directly with the providers’ documentation and productivity
  • Assist in monthly audits
  • Determine and assess patient records, review accounts receivable activities, and collect payment
  • Responsible for communication with clinicians on a regular basis
  • Responsible for coding and billing accuracy to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices
  • Responsible for complete and accurate Patient Demographic Information
  • Follow up on rejected and/or unpaid claims according to standards
  • Regulatory Billing Practices Audit & Analysis
  • Determine accuracy of Insurance Payments and follow up on discrepancies
  • Run and build reports as required
  • Review and appeal unpaid and denied claims
  • Monitor A/R and Collections
  • Identify and bill secondary or tertiary insurances
  • Respond to patient and/or insurance companies billing questions
  • Execute work on assigned claim worklists, AR worklists, reporting, or projects
  • Communicate trends and root issues through proper lines of reporting
  • Provide support to medical providers and practice specialists as appropriate regarding coding compliance documentation
  • Meet productivity and Key Performance Indicator standards
  • This position may also require light travel to the practices (POV mileage will be reimbursed)
  • Other duties as assigned

Open to candidates in Arizona, California, Colorado, Florida, Hawaii, Illinois, Michigan, Nevada, North Carolina, South Carolina, Texas, Virginia, and West Virginia.

Requirements:
  • Ability to use independent judgment and to manage and impart confidential information
  • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation
  • Knowledge of all Insurance guidelines especially Medicare and Medicaid according to standards
  • Ability to communicate logically and clearly both orally and in writing


Education and Experience

  • High school diploma or equivalent
  • Minimum of 3 years’ experience interpreting insurance explanation of benefits
  • Minimum of 3 years’ experience with medical claims, billing, payment posting and insurance collections
  • Certified Professional Coder (CPC) required


About Balance Health


Balance Health empowers people to live full lives by helping them improve and maintain mobility. We do this by bringing together leading podiatrists, orthopedic surgeons, vascular surgeons, and physical therapists and providing them the tools and resources necessary to deliver exceptional patient care. This mission has made us the fastest growing lower-extremity focused Physician Practice.