Certified Coder/Billing Representative II, Full time, Days - AMG Cardiology - Morristown

Atlantic Health System•Morristown, NJ

1d•$24 - $40•Onsite

About The Position

Responsible for the accurate enrollment and billing process. Maintains related documents, updates corresponding records and responsible for enrollment and billing queries. Collaborates with the billing service function to support electronic and technical operations. Handles complex enrollment or billing issues and reports to the manager with the relevant updates. Candidate will be responsible for coding vascular services, obtaining insurance pre-certifications, prior authorizations, and referrals for medical procedures, diagnostic testing, medications, and specialty services.

Requirements

Accurate enrollment and billing process
Maintaining related documents
Updating corresponding records
Handling enrollment and billing queries
Coding vascular services
Obtaining insurance pre-certifications, prior authorizations, and referrals for medical procedures, diagnostic testing, medications, and specialty services
Analyzing patient medical records
Communicating with insurance providers
Handling denials
Preparing appeals
Maintaining accurate records of prior authorizations requests, approvals, denials, and peer to peer reviews
Documenting all authorization requests, approvals and denials in patients’ records
Confirming patients’ insurance policy covers proposed procedure
Ensuring compliance with payer policies and procedures
Documenting all communication and authorization details in EPIC
Communicating authorization status to patients or medical staff
Obtaining referrals from outside providers
Assisting billers with insurance appeals
Maintaining current knowledge of insurance guidelines and pre-certification requirements
Answering billing- insurance questions for department team members
Assisting patients with inquiries or complaints
Reviewing and assigning procedure and diagnostic codes for vascular surgery clinicians
Reconciling posted charges using Schedule, EPIC and Zotec reporting
Monitoring office visit work queue
Reviewing clinical office notes for vascular surgeons
Reconciling appointment sessions using EPIC and Scheduling
Assisting billing staff with inquiries

Responsibilities

Reconcile and code vascular surgery services for 15 clinicians.
Authorization Initiation- Obtaining necessary documentation, submitting requests and following up on pending requests and tracking their status.
Review Medical Records- Analyze patient medical records, including diagnosis, treatments and procedures, to support authorization request.
Communicating with insurance providers, requesting additional information, handling denials and addressing any issues related to authorization, denials or delays.
Review and analyze denial letters, coordinate peer to peer reviews with physicians, prepare appeals and work to secure final authorization.
Maintaining accurate records of prior authorizations requests, approvals, denials, and peer to peer reviews.
Documenting all authorization requests, approvals and denials in patients’ records (Referral- communications)
Confirm the patients’ insurance policy covers proposed procedure.
Ensure compliance with payer policies and procedures to avoid denials.
Document all communication and authorization details in EPIC.
Communicate authorization status (denial-delays) to patients or medical staff.
Obtain referrals from outside providers when needed.
Assist billers with insurance appeals should a claim deny.
Actively maintain current knowledge of insurance guidelines and pre-certification requirements.
Answer billing- insurance questions for department team members.
Assist patients with inquiries or complaints.
Review and assign procedure and diagnostic codes for vascular surgery clinicians. To include hospital surgeries, consultations, progress notes and IR procedures.
Reconcile posted charges using Schedule, EPIC and Zotec reporting.
Monitoring office visit work queue to forecast charge entry volume.
Review clinical office notes for vascular surgeons, to ensure documentation supports assigned CPT code. Submit to Zotec.
Reconcile appointment sessions using EPIC and Scheduling to confirm all charges completed.
Assist billing staff with inquiries as needed.

Benefits

Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
Life & AD&D Insurance.
Short-Term and Long-Term Disability (with options to supplement)
403(b) Retirement Plan: Employer match, additional non-elective contribution
PTO & Paid Sick Leave
Tuition Assistance, Advancement & Academic Advising
Parental, Adoption, Surrogacy Leave
Backup and On-Site Childcare
Well-Being Rewards
Employee Assistance Program (EAP)
Fertility Benefits, Healthy Pregnancy Program
Flexible Spending & Commuter Accounts
Pet, Home & Auto, Identity Theft and Legal Insurance