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Healthcare Billing and Coding Expert

2 months ago

Dallas, Texas, United States Prism Health North Texas Full time
Job Overview

Company: Prism Health North Texas

Position: Billing & Coding Specialist

Role Summary:
The Billing & Coding Specialist plays a crucial role in overseeing the charge capture, coding, billing, and reimbursement processes within a diverse healthcare setting. This position is vital for ensuring the precision and promptness of claims submissions.

Key Responsibilities:

  • Charge Capture: Convert completed patient visits into claims for various health services including medical, dental, and behavioral health.
  • Claims Review: Ensure the accuracy and completeness of claims coding prior to submission.
  • Claims Management: Scrutinize, submit, and track claims, addressing any rejections as necessary.
  • Denial Management: Investigate and resolve claim denials, preparing necessary appeals.
  • Compliance Oversight: Conduct coding and billing compliance evaluations and provide necessary training.
  • EHR Support: Engage in the implementation and troubleshooting of Electronic Health Records.
  • Billing Oversight: Monitor billing software dashboards and manage accounts receivable.
  • Collaboration: Work alongside clinic management, healthcare providers, and external billing services.
  • Professional Communication: Exhibit professionalism in all communications with both internal and external stakeholders.

Qualifications:

  • Certification in Medical and/or Dental Coding is mandatory.
  • Experience in coding and billing within an outpatient practice is essential.
  • Familiarity with billing processes for medical, behavioral health, and dental services.
  • Proficient in MS Word, Excel, and Electronic Health Records.
  • Excellent written and verbal communication skills.
  • Strong technical skills and business insight.

Education and Experience Requirements:

  • A High School Diploma or equivalent is required; an Associate or Bachelor's degree is preferred.
  • Experience in a Federally Qualified Health Center (FQHC) is advantageous.
  • Familiarity with Ryan White and/or Title V funding is a plus.