Medical Coding and Billing Specialist

2 weeks ago


Highlands Ranch CO United States OnPoint Medical Group Full time

Company Overview: OnPoint Medical Group is a physician-led network dedicated to enhancing access to quality healthcare through a collaborative approach among skilled Primary and Urgent care providers.

Mission: Our primary objective is to ensure the health and wellness of our members and their families by offering a comprehensive range of medical services from a unified physician group within their communities.

Role Summary: We are seeking a proficient Medical Coding and Billing Specialist to join our dynamic team. Under the supervision of the coding manager and revenue cycle management team, this role involves accurately interpreting documentation and ensuring the correct application of CPT, ICD10, and HCPCS codes for billing purposes.

Key Responsibilities:

  1. Accounts Receivable: Collaborate with insurance companies and healthcare providers to ensure adherence to coding standards. Review documentation as requested by billing staff to address coding denials.
  2. Coding: Review medical records and accurately code charges. Communicate with providers for clarification on discrepancies between billed codes and documentation. Follow company initiatives to bill codes with the highest level of specificity.
  3. Productivity: Submit a minimum of 100 claims daily and report missing documentation to the practice manager at least twice weekly.
  4. Compliance: Adhere to the Billing Compliance Plan and follow Local, State, and Federal Billing Guidelines, as well as contracted payer guidelines. Maintain strict privacy, confidentiality, and safety protocols in accordance with government regulations, including HIPAA, OSHA, and PCI DSS.
  5. Administrative Duties: Maintain an organized and clean work environment.

Qualifications: To excel in this role, candidates must meet the following criteria:

  • High School Diploma or equivalent.
  • Strong computer proficiency.
  • A minimum of 5 years of experience in healthcare.
  • At least 2 years of coding and billing experience.
  • CPC Certification is required.

Preferred Qualifications:

  • Some college education in medical, business, or accounting fields.
  • Bilingual candidates are encouraged to apply.
  • Experience with EMR systems, particularly Athenahealth.
  • Certification as a coder or 5 years of experience in billing, coding, or insurance knowledge.

Working Conditions: The role requires regular standing, using hands for tasks, reaching, and effective communication. Occasional walking, sitting, and lifting of up to 25 pounds may be necessary. Specific vision abilities required include close vision and the ability to adjust focus.

Benefits:

  • Health insurance options for employees and dependents.
  • Dental and vision coverage for employees and qualified dependents.
  • Company-paid life insurance.
  • Voluntary short-term and long-term disability coverage options.
  • AFLAC plans available.
  • Eligibility for 401(k) after 6 months of employment with a 4% match that vests immediately.
  • Accrued Paid Time Off (PTO).

Compensation: The hourly wage for this position ranges from $26 to $31, depending on experience and qualifications.



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