The Medical Billing Coder provides timely and accurate processing of multi-specialty physician office visits, I/P and surgical hospital visits, and procedural coding in an academic environment. Reviews and corrects charges submitted from the clinic and hospital electronic health record using CPT, HCPCS, ICD-10 and insurance payer standards. Follows-up with accounts receivable on unpaid insurance claims. Corrects denials and audit trails. Responds to patient statement inquiries. Supports medical billing services for the College of Community Health Sciences (CCHS). Prepares and submits clean claims to various insurance companies either electronically or by paper. Reviews and verifies that documentation supports diagnoses, procedures and treatment results. Trends problems in billing and coding and provides timely feedback to Supervisor. Advises Faculty, Residents, other learners, and clinical staff regarding proper documentation and coding services. Resolves coding edits at the time of charge entry to ensure timely claim submission. Answers questions from patients, clinicians, clerical staff and insurance companies. Identifies and resolves patient billing inquiries. Evaluates patient’s financial status and establishes budget payment plans. Identifies and flags delinquent accounts for submission to the collection agency. Completes worklog tasks and outstanding accounts receivable reports by contacting insurance companies to resolve denials; submits appeals and calls patients to resolve COB issues. Processes payments from patients and prepares End of Day reports. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
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Job Type
Full-time
Career Level
Mid Level