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Specialist, Medical Billing and Coding
2 weeks ago
JOB TITLE:
Specialist, Medical Billing and Coding
JOB LOCATION:
New York, NY
JOB TYPE:
Contract
JOB DESCRIPTION:
- Partners with Operations to resolve issues surrounding unbilled claims, authorizations, Physician Certification Statements (PCSs), Patient Care Reports (PCRs), and insurance and demographic capture issues.
- Responsible for escalating concerns regarding questionable paperwork to appropriate management.
- Contact payers to verify claim status via phone or web and follow up on unpaid claims
- Process appeals on aged insurance claims/denials.
- Ability to analyze, identify and resolve issues which may cause payer payment delays
- Identify and resolve claim edits through understanding of billing guidelines and payer requirements.
- Reconcile commercial and government accounts, ensuring CPT and diagnostic codes are accurate.
- Interpret terms for Managed Care, Commercial, Medicare, Medicaid and Workers' Compensation and No Fault when applicable.
- Review all EOBs for correct payment, deductible, adjustments, and denials.
- Determining the status of claims with the insurance company, if the claim meets contractual agreements or needs adjustment.
- Reconcile account balances, and verify payments are applied correctly.
- Maintain well aged accounts, promptly resolve, and resubmit denied unpaid claims in a timely and efficient manner.
- Follow up on appeals/corrected submitted claims.
- Review and correct billing errors, which require a strong knowledge of CPT and ICD-10 coding.
- Review and audit customer service account inquiries.
- Receive inbound/outbound customer service call.
- Provide excellent customer service to all patients, Insurances & Facilities.
- Review and correct all rejections in clearing house.
- Perform all other related duties as assigned.
REQUIREMENTS:
- Must have 2-3 years of medical billing experience (required)
- Ambulance billing experience (preferred)
- Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation
- Proficient in CPT and ICD-10 coding
- Ambulance/Medical billing certification or diploma preferred
- Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) preferred
- Excellent organizational skills and the ability to multitask in a fast-paced environment
- Analytical - collects and researches data; uses intuition and experience to complement data
COMPENSATION:
$25 / hour
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