Job Description

MEDICAL CODING AND BILLING SPECIALIST

Department: HR/ACCOUNTING

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Duties and Responsibilities

• Prepares and submits clean claims to various insurance companies either electronically or by paper.
• Answers questions from patients and Insurance companies.
• Identifies and resolves patient billing complaints.
• Prepares, reviews and sends patient statements
• Evaluates patient’s financial status and establishes budget payment plans.
• Follows and reports status of delinquent account
• Makes recommendations for delinquent accounts to be forwarded to collection agencies.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
• Processes payments from insurance companies
• Translates patient information into alphanumeric and numeric medical codes
• Investigates and corrects rejected and denied claims
• Participates in educational activities and attend weekly, monthly and quarterly staff meetings
• Maintains strict confidentiality and adhere to all HIPAA guidelines and regulations

Other Skills and Requirements

•Experience in billing insurance and posting payments
•Strong computer skills
•Creative problem solving skills with the ability to multi-task and prioritize business requirements in a dynamic, fast paced environment.
•Ability to think and work creatively and effectively in a rapidly changing environment.
•Exceptional customer service orientation with a focus on collaboration and flexibility when working with both external and internal stakeholders.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit; use hands to handle or feel; and reach with hands and arms. The employee is occasionally required to stand or walk with the ability to lift up to 25 pounds at times.

Position Type/Expected Hours of Work

The employee must be available during the “core” work hours of 8:00a.m. to 5:00 p.m., Monday through Friday.

Travel

No travel is required for this position.

Required Language Skills

Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

Additional Eligibility Qualifications

None required for this position.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

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