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Certified Medical Biller

2 months ago

Westbury, United States PsychiaTreat Full time

PsychiaTreat's mission is to provide comprehensive, personalized, compassionate, and evidence-based care to people suffering from mental health disorders. We are dedicated to offering a wide range of therapeutic modalities ranging from medication management, psychotherapy, and cutting-edge treatments.

We deliver an in-depth psychiatric evaluation that determines the best treatment for the individual. This can include pharmacologic management as well as individual or group psychotherapy. Every treatment plan is tailor-made to the patient’s needs.

PsychiaTreat is also a safe and welcoming space for all people including the LGBTQAI+ community. In addition to in-person visits we also offer telehealth services.

Our medical billing specialists are responsible for correctly coding mental healthcare claims in order to obtain reimbursement from insurance companies. They review claims data to ensure that assigned diagnosis and CPT codes meet required medical necessity prior to submission. Analyze and resolve insurance denials and correspond with insurance companies and healthcare professionals to resolve any issues.

A. Governance Responsibilities

  1. Responsible to follow all guidelines of the Bureau of Primary Health Care, US Department of Health and Human Services, New York State Department of Health and New York State Department of Labor; including, OSHA, HIPAA and Abuse Reporting, and the policies and procedures and the Personnel Policy Handbook of PsychiaTreat
  2. Maintain patient confidentiality at all times as per HIPAA Law and PsychiaTreat policies and procedures.
  3. Responsible to report any findings of any type of violation to the Chief Operations Officer and to the Chief Compliance Officer as soon as you observe any violation or as soon as a violation is brought to your attention.
  4. Project assignments must meet goals and deadlines.

B. Key Responsibilities

  1. Assign appropriate ICD10/CPT codes to patient visits based on the legal medical record
  2. Translate the healthcare provider's diagnostic and procedural phrases into a coded form
  3. Obtain necessary clarification of information on the notes and charts from the provider
  4. Identify missing or incomplete medical records
  5. Review claim edits/errors within the billing system to ensure accuracy of coding and billing requirements
  6. Complying with medical coding guidelines and policies
  7. Review, research and respond to provider and operating management inquiries about the coding of visits
  8. Promote an atmosphere of open communication, teamwork, and staff input in the decision-making process
  9. Generate Excel spreadsheets for special projects as assigned and perform other duties as required

D. General Responsibilities

1. Responsible for various special projects, as needed.

2. Responsible to assign all your duties when you are not at the Center

3. Must be available for training and/or administrative meetings and sessions during Center’s scheduled hours.

4. Participate in multi-discipline team conferences, mandated service-training programs, educational activities, seminars, health fairs, training opportunities, and so forth as directed in an effort to ascertain the Center’s short and long range plans, programs and goals within areas of responsibility

E. Skills and Qualifications

● High School Diploma or GED (Required)
● Active CPC certification (Preferred)
● 5+ years ICD-10/Coding and EMR/EHR experience (Required)
● Strong organization, critical thinking and problem resolution skills
● Background check required

F. Benefits

  • Competitive starting salary
  • Bonus incentives 
  • Generous PTO days 
  • And so much more