Busy Family Practice office seeks highly motivated Medical Billing and Coding Specialist to join our team.

Responsibilities Include:

Charge Entry and Payment Posting:

Performs a comprehensive review of the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and all other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.
Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code
Works with providers, coders, billers, clinical and non-clinical office staff to answer coding questions and provide guidance as needed.
Posts payments in a timely fashion.
Reviews payment postings for accuracy and to ensure account balances are current.
Update patient registration including setting payment expectations for insured and self-pay patients, perform eligibility verifications, create claims, contact patients with outstanding balances, and work front-end edits and denials

Claims Processing:

Consistently processes claims correctly within a timely fashion and reviews for any claim holds that are coding in nature and makes changes as appropriate.
Researches problems to ensure clean claim submission, maximum reimbursement.
Works follow-up timely and accurately to ensure maximum reimbursement for services rendered.

Accounts Receivable:

Monitors delinquent accounts and performs collection duties.
Contacts patients to secure past due balances, verify patient demographics and insurance providers, updates information in systems, and documents conversations.
Answers patient’s payment, billing, and insurance questions and resolves complaints.
Maintains credit balances of patients and payors ensuring timely refunds.

Credentialing: (knowledge a plus but not required)

Responsible for initializing and maintaining privileges for all payors for all providers.
Maintaining licensure such as DEA, medical license and privilege licenses
Maintain CAQH database
Process insurance attestation/document requests.
Routinely follow up on the progress of applications until their completion
Attain provider signatures when necessary for credentialing documents
Professionally communicate with providers

Collaboration:

Works with staff and doctors to execute changes and/or enhancements to ensure valid and compliant claim status for billing.
Willingness to gain knowledge to improve self and position.
Performs other related duties, which may be inclusive, but not listed in the job description

Time Management:

Consistently strives to set priorities for efficient and productive use of time.
Performs additional work load with little or no assistance from co-workers. Works well independently without constant supervision.

Other Skills and/or Knowledge Required:

Knowledge and experience with CPT4, HCPCS, Revenue and ICD-10 coding language -Certified Professional Coder (preferred)
Insurance Carrier knowledgeable (required)
Major Carrier reimbursement policy familiarity (required)
The ability to evaluate practice process and make viable recommendations for improvement
Excellent written and verbal communication skills
Knowledge and understanding of MIPS/MACRA
Experience with EHR software
At least 3 years experience.

Job Type: Part-Time/Temporary

Job Type: Temporary

Benefits:

Schedule:

Work Location: Hybrid remote in Hertford, NC 27944

Coastal Carolina Family Practice Hiring for Medical Billing and Coding Specialist Job at Hertford, NC Full Time

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