Specialist, Medical Billing and Coding

2 weeks ago


New York, United States Judit Inc Full time
Job DescriptionJob Description

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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