Medical Billing and Coding Specialist
2 weeks ago
The Medical Billing and Coding Specialist plays a critical role in ensuring the accurate and timely processing of medical claims. This position requires a strong understanding of medical billing and coding principles, as well as excellent communication and interpersonal skills.
Key Responsibilities- Assigning codes to medical procedures, diagnoses, treatments, and services
- Preparing and sending invoices or claims for payment, and correcting rejected claims
- Following up with patients and insurance companies about outstanding bills, and keeping track of overdue payments
- Acting as a liaison between the agency, clients, and insurance companies
- Monitoring and processing patient data, such as treatment records, insurance plan information, and payment data
- Communicating with other members of the agency
- Gathering information from the team to complete prior authorizations
- Completing prior authorizations in MCO and Medicaid UM portals
- Maintaining a spreadsheet with dates and units remaining to re-authorize in a timely manner
- Completing authorizations and prior-authorizations for clients who are new or have exhausted units
- Referencing patients to outside specialists or agencies when necessary
- Maintaining thorough records of patient meetings and progress, both in electronic and paper records, meeting or exceeding Medicaid documentation expectations
- Following all safety protocols and maintaining client confidentiality
- Contributing to practice by accomplishing related tasks as needed
- Completing and maintaining updated authorizations and units of clients
- Navigating UM Medicaid and MCO portals
- Completing intensive outpatient billing and authorizations
- Completing SUD residential billing and authorizations
- Completing outpatient billing and authorizations
- Completing credentialing processes for the agency
- Participating in audits and reviews
- Maintaining updated spreadsheets on Microsoft TEAMS
- Maintaining updated calendars in Outlook and electronic scheduling records
- Attending trainings and meetings as assigned
- Staying up to date with current trends, technologies
- HS diploma or GED required
- Knowledge of Medicaid UM and billing required
- Clear criminal and CPS/APS background required
- Associates or Bachelors degree preferred
- Medical billing and coding certificate preferred
- Financial and accounting background preferred
- Strong Interpersonal skills
- Excellent Communication skills
- Ability to navigate online portals
- Understanding of medical billing and coding
- Ability to work with deadlines
- Ability to complete tasks without or with minimal supervision
- Strong understanding of prior authorizations
- Detail oriented
- Strong ability to manage time and prioritize tasks
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