Billing and Coding Specialist

BAMF Health

About The Position

Join BAMF Health, where you're not just part of a team; you're at the forefront of a revolution in Theranostics, changing lives for the better. As a member of our global team, you'll contribute to pioneering technology and deliver top-tier patient care. Located in the heart of downtown Grand Rapids, our cutting-edge global headquarters resides within the state-of-the-art Doug Meijer Medical Innovation Building. Step into our modern and spacious facilities, where innovation thrives and collaboration knows no bounds. Join us in our mission to make Theranostics accessible and affordable for all, and be part of something truly remarkable at BAMF Health. The Billing and Coding Specialist is responsible for transferring patient and insurance information and initiating payment processes and procedures. Works with billing software, coding, medical insurance regulations, and is an expert at responding to patient and insurance inquiries.

Requirements

Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or associate degree in health information technology or a related field or an equivalent combination of years of education and experience is required.
1 year of outpatient coding experience is required

Nice To Haves

Bachelor’s degree in health information management (HIM) or related healthcare field preferred.
3 years of outpatient coding experience is preferred
Strong customer service skills and comfortable answering both patient and insurance company questions
Extensive comprehensive working knowledge of medical terminology, Anatomy and Physiology, diagnostic and procedural coding and MS-DRG or APC grouping.
Experience with OON provider as well as experience working in Athena preferred.
Proficient computer skills, Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel); working knowledge of billing software (ECW) preferred.
Current experience performing remote coding is preferred.

Responsibilities

Collaborates with intra-departmental team on denial investigations and root cause analysis, which includes identifying opportunities for denial prevention along the revenue cycle.
Maintains denial and/or audit logs and assessments in accordance with associated guidelines.
Complete, thorough, and timely research and resolution of all aging, denied, rejected claims.
Maintains an understanding of regulatory and payer changes to assure correct charging and billing requirements are met.
Maintains working knowledge of coding and billing regulations for all payors.
Keeps current on regulatory updates, local payer policies and procedures to ensure charge accuracy, compliance, and optimization.
Maintains a working knowledge of applicable Federal, State, and local laws/regulations.
Follows Insurance and Patient Aging for complete resolution of accounts.
Account follow up includes resolving disputes with insurance companies for corrected billing.
Assist with posting payments and adjustment for the Explanation of Benefits (EOB).
Utilizes coding guidelines established by the Centers for Medicare/Medicaid Services (CMS), American Hospital Association (AHA) Coding Clinic, American Medical Association (AMA), American Health Information Management Association (AHIMA) Standards of Ethical Coding, Revenue Excellence/Regional Health Ministry (RHM) coding policies.
Responsible for reviewing medical records, abstracting, and analyzing physician documentation, and consulting with physicians in assigning appropriate clinical diagnosis and accurate documentation in alignment with CMS risk adjustment methodology.

Benefits

Employer paid High Deductible Health Plan with employer HSA contribution
Flexible Vacation Time
401(k) Retirement Plan with generous employer match
Several benefit options including, but not limited to; dental, vision, disability, life, supplemental coverages, legal and identity protection

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