Medical Billing and Coding Specialist
Company: ACCESS (MI)
Location: Dearborn
Posted on: May 23, 2023
Job Description:
Job Title: Medical Billing and Coding Specialist
Job Status:Full-Time
***COVID-19 VACCINATIONS: ACCESS requires all newly hired employees
in certain departments/programs (except those with bona fide
medical and religious exemptions) to provide proof of up- to-date
vaccination against COVID-19 before beginning employment.***
Job Summary: Under close supervision, the Medical Billing and
Coding Specialist is responsible for processing health insurance
claims for services provided at all clinics. Employee is
responsible for submitting claims for reimbursement and coach
healthcare providers to achieve optimal reimbursements.
Essential Duties and Responsibilities:
- Verify the provider's determination of services provided and
patient diagnoses via office and operative notes
- Enter charges in the billing system and/or reviews
- Maintain complete knowledge and comply with all relevant
insurance, CPT coding and diagnosis guidelines, disseminating info
to staff and providers as necessary
- Review quarterly provider audits, researching proper coding
when necessary and working with coding and compliance as
needed
- Create relationships with external organizations that allow for
streamlining and quick resolution of billing matters for
patients
- Document conversations with insurance companies and
patients
- Audit agency reports for procedures with office billing to
ensure accuracy of billing to payers
- Audit EMR entries to verify correct insurance and demographic
information
- Attend regularly scheduled meetings
- Coordinate and follow through with special projects as
assigned
- Create a positive, professional, service-oriented work
environment for staff, clients and family members by supporting the
ACCESS mission and core values statement
- Use a special coding system to choose diagnosis and procedure
codes
- Enter the correct codes into patients' electronic health
records
- Review claims to make sure coding is accurate
- Work with other staff members to ensure accuracy
- Enter insurance claims into specialized billing programs
- Interact with patients when insurance matters need to be
clarified
- Follow up with insurers about any late payments
- Track payments to make sure reimbursements are received on
time
- Keep in tune with changes and advancements in the field
- May be responsible for credentialing
- Operate standard office equipment and use required software
applications
- Perform other duties and responsibilities as assigned
Knowledge, Skills and Abilities:
Knowledge of:
- Billing and managed care department basic services and hours of
operation to respond to customer requests accurately
- Medical, including surgical, terminology and procedures at the
level needed to perform job responsibilities, including
understanding of CPT and ICD-9/ICD-10 coding
- Rules and regulations regarding insurance claim submissions
Skill in:
- Operating standard office equipment and using required software
applications for program area and other applications, including
Microsoft Office
- Critical thinking with the ability to effectively problem solve
(e.g. able to determine if a patient issue requires immediate
provider attention if there are significant changes to the patient
history or other clinical issues that are presented)
- Strong customer service skills
- Strong multi-tasking skills
- Organizational and time management skills to effectively juggle
multiple priorities, time constraints and large volumes of work
Ability to:
- Operate a standard desktop and Windows-based computer system,
including but not limited to, electronic medical records, Microsoft
Word, Excel, Outlook, intranet and computer navigation
- Use other software as required while performing the essential
functions of the job
- Communicate effectively with both written and verbal forms,
including proper phone etiquette
- Work collaboratively in a team-oriented environment; courteous
and friendly demeanor
- Work effectively with various levels of organizational members
and diverse populations including ACCESS staff, patients, family
members, insurance carriers, outside customers, vendors and
couriers
- Cross-train in other areas of practice in order to achieve
smooth flow of all operations
- Exercise sound judgment and problem-solving skills,
specifically as it relates to resolving billing and coding
problems
- Handle patient and organizational information in a confidential
manner
- Work under minimal supervision Educational/Previous Experience
Requirements:
- Minimum Degree Required:
- Associate degree
- Bachelor's degree preferred
- At least 3-5 years previous clinical billing experience or
equivalent combination of education, experience and/or training
approved by Human Resources. Licenses/Certifications:
- Licenses/Certifications Required at Date of Hire:
- Medical Billing and Coding Certificate or Degree in field,
Certified Professional Coder (CPC), Nationally Registered Certified
Coding Specialist (NRCCS) or Registered Health Information
Technician (RHIT)
Working Conditions:
Hours: Normal business hours, some additional hours may be
required
Travel Required: Local travel may be required
Working Environment: Climate controlled office
Keywords: ACCESS (MI), Dearborn , Medical Billing and Coding Specialist, Healthcare , Dearborn, Michigan
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