Documentation and Reimbursement Specialist

Schedule

On-site until cleared to work hybrid (onsite 2 days per month after probationary period) - subject to change based on meetings.

Job Description

• Researches and responds to coding, documentation, compliance, and reimbursement inquiries.
• Provides compliance and documentation education sessions to physicians and staff.
• Clears ambiguous clinical data and provides feedback for improved documentation.
• Solves billing discrepancies and issues with insurance providers.
• Collaborates with healthcare providers to gather necessary documentation for claims.
• Updates billing software with relevant patient and insurance information.

Education Requirement

As required by listed licensure and/or certification requirement. Bachelor’s Degree, preferred.

Licensure Requirement

(not specified)

Certifications Required

• Certified Coding Specialist Physician Based (CCS-P) Certification by the American Health Information Management Association (AHIMA).
• Certified Professional Coder (CPC) certification by the American Academy of Professional Coders.

Skills

• Proficiency with third party billing and documentation standards, particularly Evaluation and Management is essential.
• Knowledge of medical terminology and proficiency with diagnosis and CPT4 coding required.
• Excellent verbal and written communication skills.
• Able to maintain and establish strong working relationships with physicians, support staff, and external parties.
• Able to work both as a team player and independently.
• Strong analytical abilities.
• Demonstrated aptitude for quantitative analysis and attention to detail.
• Strong problem solving, collaboration, and interpersonal skills.
• Able to balance multiple priorities and deadlines.
• Proficiency with personal computers and related software.
• Attention to patient confidentiality.

Experience

• Five years of experience in related field (physician billing experience), preferred.
• One year of education or teaching related experience, required.

Physical Requirements

• OCCASIONALLY: Driving motor vehicles (work required)
• STANDING: Decision Making, Interpreting Data, Problem solving
• CONTINUOUSLY: Audible speech, Computer skills, Flexing/extending of neck, Hand use: grasping, gripping, turning, Hearing acuity, Repetitive hand/arm use, Seeing – Far/near, Sitting

Additional Physical Requirements

(not specified)