Billers/Certified Coders

» Billers/Certified Coders
Healthcare
in Miramar
, FL
Reference: 19-01417

Overall Position Description:

  • The Biller’s role is to accurately enter all of the billing information, coding and charges into the billing system

Primary Objective:

  • The primary objective of is to review, interpret, obtain missing documentation, code and enter all billing information accurately and efficiently to obtain a maximal revenue cycle

General Areas of Responsibility:

  • Enter billing information into multiple billing software
  • Audit the billing information received and gather all the missing documentation
  • Daily reconciliation to ensure that all charges are captured and billed daily and within set departmental time frames
  • Preparing all necessary documentation needed to build a claim or statement
  • Assist in resubmitting denials for payment based on coding guidelines with supported documentation

Required Knowledge, Skills and Abilities:

  • Minimum of one year of experience in Medical Billing
  • Working knowledge of insurance carriers’ payment regulations including various reimbursement schemes, coinsurance and deductibles, and contractual adjustments
  • Knowledge of Medicare, Managed Care and Commercial insurances
  • Strong knowledge of ICD-9, CPT4, HCPCs codes
  • Knowledge of HIPPA regulations
  • Demonstrated success working in a team environment focused on meeting organizational goals and objectives
  • Technical aptitude
  • Great attention to detail
  • Must possess excellent oral and written communication skills
  • Must be able to work in a high volume and busy environment
  • Strong proficiency in multi-tasking
  • Superior organizational and follow-up skills

Qualifications:

  • Minimum one year of experience in billing is preferred
  • Minimum (2) years experience in outpatient coding and/or Health Information Management required
  • Minimum (1) year of experience in a medical office setting highly preferred (i.e. ambulatory surgery center, hospital, doctors office) preferred
  • Coding certification from AAPC, AHEMA preferred
  • BLS may be required as per facility standard

Education:

  • Coding certified – CPC from AAPC or AHIMA preferred
  • High school some college preferred
  • Registered Health Information Technician (RHIT) or Registered Health Information Administrators (RHIA) college degree preferred
  • Completed coursework in Human Anatomy & Physiology, Medical Terminology, Introduction to Coding (including ICD-9 and CPT) preferred

Duties:

  • Codes outpatient surgery center(s) records in a timely manner, including the assignment of ICD-9-CM, E/M, Procedure Categories, modifiers (when applicable), and HCPCS/CPT procedure codes
  • Resolves/clarifies codes and diagnosis with conflicting, missing, or unclear information by appropriately utilizing the query tool to get additional information from the Medical Staff as necessary
  • Ensures that 3M encoder updates are processed timely/upon receipt to ensure use of the most current coding information
  • Codes billing supplies and implants; furnishes completed coding information as necessary to bill cases
  • Assists business office management with any special projects related to coding issues or questions that may include medical records audits and other coding/HIM support, as appropriate
  • Collects data and prepares reports of findings
  • Assists with preparation for AAAHC and/or State reviews
  • Shares knowledge of the reporting and the disposition of medical records (statistical reports)
  • Guides others to follow the state standards related to the release of information from medical records and assists with determining the appropriate release of medical information
  • Initiates physician queries in compliance with ASD guidelines/policies where appropriate
  • Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
  • Utilizes the complete medical record’s documentation in code assignment
  • Consults with the business office management for assistance with resolving issues, as needed
  • Meets all educational requirements as stated in the client’s policies
  • Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”
  • Other duties as assigned based on business operational needs

Physical Demands/Working Conditions:

  • Requires prolonged sitting, some bending, stooping and stretching
  • Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, computer, photocopier, telephone, calculator, and other office equipment
  • Requires normal range of hearing/eyesight/voice projection to record, prepare, and communicate appropriately
  • Requires occasional lifting up to 50 pounds
  • Work is performed in an office environment
  • Work may involve dealing with angry or upset people and may be stressful at times