Billing Coding Specialist (59138)

CIRCLE THE CITY • Phoenix, AZ

1d • Onsite

About The Position

The Billing Coding Specialist is primarily responsible for the coding/billing, and resolution of denied claims.

Requirements

• Must be (at least) 21 years old.
• Solid understanding of billing software and electronic medical records.
• Understanding of relevant laws and best practices as it relates to Medicare and Medicaid billing.
• Ability to problem solve and develop solutions.
• Understanding of HIPAA regulations and medical terminology.
• High school diploma required.
• Experience with Excel required.
• 1 or more years’ experience as an outpatient coder.
• Minimum of 3 years’ experience with claims billing.

Nice To Haves

• Prefer experience with Athena system.
• Current certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) preferred.

Responsibilities

• Code claims according to coding and billing guidelines.
• Bill claims in accordance with payor guidelines.
• Investigate payer- rejected claims to determine reason for denial and work to obtain resolution.
• Prioritize and work HOLD an MGR HOLD buckets.
• Verify patient insurance coverage and eligibility.
• Update patient records with accurate insurance information.
• Manage accounts receivable and follow up on overdue payments.
• Collaborate with other departments, such as medical coding and front office, to ensure accurate and timely processes.
• Support the revenue cycle by ensuring clai8ms are dropped within 2 days of current date.
• Assist in general administrative tasks as needed.
• Review all claims returned for Medical Necessity and correct if able; report findings to Team Lead.
• Follows established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety and environmental standards.
• Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.
• Performs other duties as required.
• Other Duties as presented by supervisor and/or Directors.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED