Medical Billing & Collections Specialist - Part Time (ASC/ Surgical- Remote Charlotte Area)

Responsibilities

• Review medical records for documentation accuracy and assign the correct CPT and ICD-10 codes to the claim.
• May conduct or assign audit reviews of coding and procedures specification.
• Performs and oversees all billing processes, including primary/secondary and rebilling, including necessary claim edits on both internal and external software systems.
• Remains knowledgeable and current on rules and regulations related to all government payers: Medicare, Medicaid, VA, etc.
• Checks clearinghouse transmission daily to ensure files are successfully transmitted to the intermediary.
• Works closely with vendors when problems or trends arise that impede work flow.
• Handles follow up on billed patient accounts to successfully collect owed balances.
• Posts payments as required via cash, credit cards, EFT and third-party vendors, etc.
• Reviews and adjudicates EOBs/RAs to determine if the Surgery Center was paid correctly by the payer.
• Deals with denials in an efficient and effective manner, handling appeals as needed to get claims paid.
• Remains actively involved in KPIs associated with the financial performance of the Surgery Center.

Physical Requirements

• The ability to lift, carry or push/pull up to 20 pounds and, occasionally, lift carry, push/pull over 20 pounds.
• Standing, walking 30% of the time, and sitting 70% of the time.
• Eye/hand coordination, finger dexterity, color perception, functional visual ability and depth perception, functional sound perception and discrimination, functional verbal speech ability.
• Occasional bending, kneeling, climbing, twisting, reach at/or above and below shoulder level.
• Routine balancing as it pertains to normal office environment duties.

Qualifications

• High school diploma required.
• An Associate degree, suitable Trade School or Coding Certification preferred.
• 2-5 years' experience in a medical environment required, with strong medical terminology knowledge, preferably in the surgical realm.
• Thorough working knowledge of CPT and ICD-10 codes and can process outgoing claims, write billing edits, transmit transaction files and process payments.
• Strong typing skills, significant computer experience, email, copier and Microsoft office experience required.
• EMR experience required. EMR experience can be from a physician practice but should include both clerical and clinical functions.
• Knowledge of ASC billing preferred.
• Knowledge of billing rules and regulations through various governmental programs is required, as well as pertinent knowledge related to commercial claim submission and a firm grasp of all HIPAA guidelines.