|Title:||Medical Billing and Coding Specialist-Finance-DB 0005 |
Responsible for reviewing, researching, coding and generating third party billing for medical services to all guarantors. Ensures accuracy of ICD-10 coding for services rendered. Performs monthly internal billing audits to ensure proper coding. Follows up on unpaid medical claims and MHC guarantors. Update monthly guarantor financial eligibility. Works closely with providers assigned to the medical center. Billing all medical claims weekly and invoice self-pay monthly.Verifies completeness and accuracy of all claims prior to submission. Regularly meet with Account Manger to discuss and resolve reimbursement issues or obstacles. Reviewing financial edibility monthly for Gracepoint clients and updating the guarantors and notifying changes to the Program Manager and Managed Care if authorization is required. Retains accurate file maintenance of EOB’s from payers and refunds. Timely follow up on insurance claim denials, exceptions or exclusions. Performs other patient accounts receivable control and review functions. Performs internal audit of charge master and billing charge audit annually. Assists with audit for evaluating billing and posting accuracy. Runs credit balance report monthly to determine timeliness of refunds. Prepares Quarterly Credit Balance report for filing with CMS. High school diploma is required. Three years of billing experience in a hospital or medical office with a coding certificate required. Proficient with accurate data entry, claims coding, billing and reconciliation. Working knowledge of ICD-10 and CPT/HCPCS coding standards. Capable of operating a 10-key calculator.
|Hours:||Mon-Fri, 8:00 am-4:30 pm|