Medical Biller/Coder

2 weeks ago

Springfield, United States Caring Health Center Full time
General Description:

Provide front-line coding support to medical providers and other staff as appropriate. Develop and conduct training/education for providers and other clinical staff in accordance with FQHC policies and procedures.

Reports to: Billing/Coding Supervisor

Supervises: N/A

Salary/Status: Non-Exempt

Minimum Requirements:
  1. Certification as a Certified Professional Coder (CPC) or equivalent preferred.
  2. Experience with compliance, coding and billing issues, as well as experience in registering patients and entering/reconciling charges in a medical billing system as needed.
  3. Ability to establish and maintain effective working relationships with third party payers, individuals seeking assistance, and the general public.
  4. Professional in behavior and appearance
  5. Ability to read and decipher chart notes to validate, correct/ and/or apply appropriate diagnosis codes to claims as needed.
  6. Computer literacy and PC application skills
  7. Must possess the ability to interact positively with Supervisor and other staff members.
  8. Ability to type at least 35 WPM
  9. Ability to work within a team as well as work independently as need.
  10. Must be willing to work on site.
Principal Responsibilities and Duties:
  1. Responsible for outpatient physician/non-physician practitioner services through review of medical records/encounter forms or EHR records.
  2. Assign CPT codes, ICD-10 codes, HCPCS II codes based on documentation, payer requirements and billing policies.
  3. Compile, complete, verify, correct and/or register insurance information for new and existing patients.
  4. Provide financial counseling to patients for outstanding self-pay account balances.
  5. Process sliding scale applications and make necessary collection and discounting decisions.
  6. Resolve coding and reimbursement issues with providers, department managers and other clinical staff.
  7. Identify opportunities to reduce denials and enhance revenue.
  8. Concurrent coding/reviewing of coding of medical records.
  9. Assist in developing and implementing a billing compliance education/training program for new providers.
  10. Provide feedback and education regarding identified deficiencies to providers and clinical staff.
  11. Serves as a resource person to providers, departments and coding staff on problems dealing with compliance and billing issues, interpretation of coding issues/guidelines, and accurate coding.
  12. Maintains library of information/tools related to documentation guidelines and coding.
  13. Maintains confidentiality of account information.
  14. Concurrently codes, records and provides ongoing feedback to providers.
  15. Educates and trains physician and non-physician providers on proper medical record documentation in compliance with FQHC guidelines for billing of medical services. Education includes the Evaluation and Management coding requirements.
  16. Assist in providing feedback for developing program/communication mechanism to inform providers and clinical staff regarding new regulatory guidelines for billing and documentation compliance.
  17. Identifies problems related to assigned duties and proposes solutions.
  18. Performs other duties as assigned by the Billing/Coding Director, Supervisor or Team Lead.
  19. Work with Billing/Coding Supervisor, Team lead, EHR training staff and/or Super user(s) of EHR/EPM system, to become proficient in all aspects of learning and using the system correctly for your assigned job duties.
  20. Other related duties.
  21. Work billing & coding work queues and perform billing & coding duties accurately and efficiently while maintaining expected productivity levels.
  22. Management has the right to change or add to the job responsibilities at any time.


This position requires the ability to use a computer workstation with an operating keyboard.

From time to time, this position may require the ability to work long and arduous hours.

JOB CODE: 1000125

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