Medical Billing and Coding Specialist

Saint Peters Healthcare System•New Brunswick, NJ

7d•$24 - $39•Onsite

About The Position

The Medical Billing and Coding Specialist will perform billing activities in a timely manner, including surgical billing, physician billing, and coding. This role may involve assisting with chart audits to identify and resolve areas for improvement. The specialist will ensure accurate and timely coding and processing of claims, manage primary holds daily for billing-related follow-up, and communicate with practice staff and physicians to identify necessary improvements. This position serves as a billing liaison between the Practices and other Saint Peter’s Healthcare System departments, as well as the physician billing vendor. The role also involves acting as a financial interpreter for patients, advising them of their financial responsibility and providing clear information about healthcare coverage prior to or at the time of service, coordinating with registrars and offering counseling when needed. Additionally, the specialist will educate and provide physicians/surgeons with diagnosis codes (ICD-10) and procedure codes (CPT) upon request. There may be involvement in educating and training office staff on claim processing, managing hold buckets, specific tasks, precertifications, and other billing functions. Ensuring timely payments by following up on denials and open accounts receivable with facility and physician billing representatives is crucial. The specialist will also assist other billing staff in resolving issues related to registration, charge entry, coding, and payment reconciliation, and perform research for billing-related projects. Recommendations for improving office procedures for efficiency, productivity, and cost-effectiveness are expected, along with maintaining an orderly and efficient work area following safety, emergency, infection control, and performance improvement guidelines.

Requirements

Requires a minimum of two (2) years of experience in an office setting, with billing and coding, and accounts receivable.
Must have the ability to use sound judgment, act independently, and organize work load effectively.
Requires outstanding interpersonal skills in order to deal effectively with a diverse group of callers, physicians, patients, visitors, and other healthcare professionals.
Ability to work efficiently in fast-paced environment, problem solve and prioritize workload.
Must be able to effectively educate physicians in medical coding and documentation guidelines.
Keyboarding skills and abilities, including MS Office programs and capability of learning in-house billing and coding programs.
CPC certification required or obtained within first year of employment.

Responsibilities

Perform billing activities in a timely manner, i.e. surgical billing, physician billing and coding; may assist with chart audits to identify areas for improvement and resolve as appropriate.
Ensure that claims are coded and processed accurately and timely.
Work the primary holds daily for all billing related follow-up and communicates with the practice staff and physicians to identify improvement when necessary.
Serve as the billing liaison between the Practices and other Saint Peter’s Healthcare System departments as well as physician billing vendor.
Assist Billing/Coding Coordinator with related projects and issues as they arise.
Act as the financial interpreter for patients by advising them of their financial responsibility, providing them with concise and easily understood information about healthcare coverage, prior to or at time of service. Coordinates activities with the registrars by offering counseling to patients when notified of the need.
Educate and provide physicians/surgeons with diagnosis codes (ICD-10) and procedure codes (CPT) when requested.
May assist with the education and training of office staff on processing office and surgery claims, managing the Athena hold buckets, IngeniousMed tasks, precertifications, and other billing related functions.
Ensure that all appropriate follow-up is done according to procedure to ensure timely payments are received. This is done by working with the facility and physician billing representatives by following up on denials and open accounts receivable.
Assist the other billing staff members in the resolution of problems related to registration, charge entry, coding and payment reconciliation.
Perform billing-related project research related to the activities of the Department.
Recommend changes in office procedures to improve efficiency, productivity and/or cost effectiveness on an ongoing basis as evidenced by departmental efficiency and/or cost savings.
Maintain an orderly and efficient work area consistently following proper safety, emergency, infection control and performance improvement guidelines.