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Medical Biller, Coder, and Scheduler
1 week ago
This position reviews, interprets and verifies diagnostic and surgical procedure codes based on operative reports according to correct coding principles. Provides feedback to physicians and management staff regarding surgical service documentation. Meets coding and abstracting deadlines to expedite the billing and charge entry process.
Coding Compliance - Identifies unbundled procedures according to CPT guidelines and current Medicare NCCI rules. Identifies other coding related denials including medical necessity and modifier usage. Provides feedback to physicians and management staff regarding denials.
Responsibilities are but are not all inclusive:
- Expert in billing and coding compliance as well as HIPAA compliance.
- Knowledgeable in fee schedules.
- Insurance verification for all insurance surgery cases at the surgery center as well as ensuring prior authorization is obtained and in place prior to surgery.
- Instruct surgery center team members with collecting copays, coinsurances, and/or deductibles amounts.
- Ensures that correct IDC 10 and CPT codes are used correctly when coding surgeries and procedures.
- Billing facility claims.
- Ensures coding is finalized and submits electronic claims to correct insurance companies in a timely manner.
- Works claim denials and sends appeals to insurance companies with correct documentation to support medical necessity.
- Enters charges in Surgery Center’s billing system.
- Enters insurance payments.
- Enters patient payments.
- Generates AR Reports and meets with Medical Director and Administrator to discuss outstanding patient accounts.
- Work outstanding account balances with insurance carriers.
- Ensures follow up on unpaid insurance claims and patient bills.
- Medical records/chart audits
- Print and mail patient statements according to the appropriate schedule.
- Contact all patients regarding outstanding patient balances at a monthly basis.
- Ensures that patient bills are processed in a timely fashion.
- Respond in a timely manner to all claims and requests for information from all payors.
**Qualifications**:
Job Behavior:
Must have knowledge of medical terminology. Demonstrates ability to work as a team member and to communicate directly and professionally. Must be flexible, reliable, productive, patient oriented and self-motivated. Upholds company’s Standards of Behavior. Maintains professional conduct and appearance.
Education Required: High school diploma and successful completion of college or relevant trade training program.
Preferred: Associate or Bachelor’s Degree
Experience
Required: ICD 10, CPT, HCPCS Coding 6 months of physician billing. At least 1 year of coding experience and/or completion of AAPC practicum course (equivalent to 1 year).
Preferred: 5 years of experience in health care billing and collection. 3 years of Outpatient Facility coding and billing experience. Knowledge of secondary or supplemental insurance claim filing (COB) is a plus. Experience with Nextech is a plus.
License(s)
Required: Certified Professional Coder (CPC-A or CPC).
Preferred: Certified Professional Coder
- Certified ASC Coder (CASCC)
Special Skills
Required:
Knowledge of ICD-9/10 codes, CPT, and HCPCs.
Working knowledge of medical terminology, anatomy, and physiology.
Excellent written and verbal communication skills; organizational skills.
Experience with an EMR.
Excellent interpersonal and customer service skills.
Excellent organizational skills and attention to details.
Excellent time management skills with a proven ability to meet deadlines.
Strong analytical and problem-solving skills.
Ability to prioritize tasks.
Understanding and knowledge of EOBs and posting payments.
Preferred: Experience with Excel.
Working Environment: Office
Pay: $18.00 - $21.00 per hour
Expected hours: 40 per week
**Benefits**:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
- Clinic
- Medical office
- Office
- Private practice
**Experience**:
- ICD-10: 1 year (preferred)
Ability to Commute:
- Tucson, AZ 85705 (required)
Work Location: In person
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