Medical Billing and Coding Specialist

3 days ago

Parkersburg, West Virginia, United States WVFSRS Full time
Job Title: Medical Billing and Coding Specialist

At WVFSRS, we are seeking a highly skilled Medical Billing and Coding Specialist to join our team. As a key member of our healthcare team, you will be responsible for ensuring accurate and timely billing and coding of medical services.

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 critical 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
  • Refer 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
Requirements:
  • 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
Certifications:
  • HIPAA
  • Adult CPR - First Aid
  • Blood Borne Pathogens
  • CPI validation required within 30 days of employment with revalidation per company policy

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