Coding/Billing Specialist - Hybrid/Remote

Responsibilities

• Reviews progress notes to determine codes meet local and national medical necessity guidelines.
• Assigns ICD-10 and CPT codes with the appropriate modifiers for services provided when posting charges.
• Be familiar with medical terminology, LCD’s, NCD’s and insurance portals to stay compliant with industry coding practices.
• Monitor payer EOB’s/system for denials and improper payments.
• Investigate and follow up on denied or rejected claims by sending corrected claims/appeals and contacting insurances as necessary.
• Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality.
• Answer phones and handle patient calls regarding accounts for billing, as needed.
• Key claims on MaineCare portal, as needed.
• Verify insurance coverage and benefits prior to submitting claims to ensure proper reimbursement.
• Collect, post and manage patient account payments.
• Collaborate with healthcare providers to resolve any discrepancies in billing or coding as requested by Billing Manager.
• Actively participates in department meetings, one-on-one meetings and mentorship meetings with billing team members.
• Serve as a resource and subject matter expert to other staff members (front office, providers, fellow team members).
• Perform other related duties as requested.

Requirements

• Certification as a Professional Coder is preferred or a combination of education and/or experience in Medical Billing and Coding.
• A High School Diploma or G.E.D.
• 1-2 years of experience in the field preferred.
• Able to have good communication skills with staff, clients, insurance companies, and the general public.
• A certain degree of creativity is expected.

Qualifications

Comprehension: Understands and applies non-routine verbal and/or written instructions.

Organization: Organize and prioritize individual work schedule to manage multiple tasks and/or projects.

Decision Making: Makes decisions that have an impact on the immediate work unit’s operation and/or services.

Communication: Communicates and explains a variety of information.

Physical Requirements: Keyboard operation and sitting for extended periods of time. Ability to lift 25 lbs.; Walking/Standing/Bending/Kneeling/Squatting; Visual acuity for extended periods of monitor operation. Ability to use interfaced communication devices (Electronic Medical Record, telephone, internet, etc.).