Medical Billing Coder

WELLSTONE • Huntsville, AL

4d

About The Position

The Medical Billing Coder is responsible for reviewing notes and submitting charges in the electronic medical record (EMR). They ensure that insurance companies and patients are billed accurately for services rendered to help to streamline WellStone’s healthcare reimbursement process. What you'll be doing: Analyze client electronic medical record and provider documentation of services provided for consistency and accuracy. Ensures the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established third-party reimbursement agencies and special screening criteria. Analyzes provider documentation to ensure the appropriate Evaluation & Management (E & M) levels are assigned using the correct standardized ICD-10 & CPT code classification systems. Abstracts all necessary information and assigns codes which most accurately describe each documented diagnosis, procedure according to established guidelines. Use alphanumeric diagnostic and procedural codes to convey critical information about illnesses and treatment. By translating medical terminology into standardized codes, information is transmitted with the efficiency that best serves the client and provider alike so that the clients’ diagnoses are accurately communicated, and provider services paid. Ensure the assigned codes meet all federal, legal and insurance regulations so service payments are obtained in a timely manner. Assist providers in understanding the correlation between documented services provided and the specific codes required to justify reimbursement of fees in order to provide consistency. Maintain ongoing monitoring of the Federal Register and alert for impending rules and regulations, proposed rules and notices that may affect or may be affected by providers. Complete other duties as assigned. This job description is only a summary of the typical functions of the job and is not designed to be an exhaustive or comprehensive list of all possible duties, tasks, or responsibilities that are required of the employee as they may change, or new ones may be assigned at any time with or without notice.

Requirements

• Advanced Education in Billing/Medical Coding
• Will consider relevant college courses if no degree
• Required 1-2 years’ experience as Medical Billing Coder
• Knowledge in mental health terminology, abbreviations, pharmacology and diagnosis
• Advanced knowledge in medical codes involving selection of the most accurate and descriptive code using CPT codes for billing of third-party resources
• Knowledge of HIPAA guidelines and compliance standards
• Advanced knowledge of CMS regulations and fraud guidelines for professionals
• Excellent verbal and written communication skills

Responsibilities

• Analyze client electronic medical record and provider documentation of services provided for consistency and accuracy.
• Ensures the final diagnosis accurately reflects the care and treatment rendered.
• Reviews the records for compliance with established third-party reimbursement agencies and special screening criteria.
• Analyzes provider documentation to ensure the appropriate Evaluation & Management (E & M) levels are assigned using the correct standardized ICD-10 & CPT code classification systems.
• Abstracts all necessary information and assigns codes which most accurately describe each documented diagnosis, procedure according to established guidelines.
• Use alphanumeric diagnostic and procedural codes to convey critical information about illnesses and treatment.
• Ensure the assigned codes meet all federal, legal and insurance regulations so service payments are obtained in a timely manner.
• Assist providers in understanding the correlation between documented services provided and the specific codes required to justify reimbursement of fees in order to provide consistency.
• Maintain ongoing monitoring of the Federal Register and alert for impending rules and regulations, proposed rules and notices that may affect or may be affected by providers.
• Complete other duties as assigned.

Benefits

• Competitive medical, dental, and vision premiums
• State Retirement participation through RSA plus an optional 457b plan with a company match
• Nine (9) paid holidays throughout the year
• Ability to continually accrue up to 15 days of PTO a year (unused rolls over)
• Company-paid Group Life and AD&D insurance and Long-Term Disability
• Licensure reimbursement
• Tuition discounts through learning partnerships with Athens State University and Capella University

What This Job Offers

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