Medical Billing Specialist

WAYNE MEMORIAL COMMUNITY HEALTH CENTERS•Honesdale, PA

5d•Onsite

About The Position

Wayne Memorial Community Health Centers (WMCHC) is seeking a Medical Billing Specialist to join the team at our Wayne Memorial CHC billing office. This position is responsible for coding and entering charges for CHC physician practices and physicians under billing agreements. WMCHC’s Mission Wayne Memorial Community Health Centers creates and sustains healthy rural communities by providing accessible, high quality medical, dental, and behavioral health care for all, while recognizing and addressing other factors that influence health outcomes. If our mission inspires you and you are willing to go the extra mile for our patients, please feel free to apply for this or future employment opportunities for which you meet the minimum qualifications. Please know that only the candidates who meet the minimum qualifications can be considered, and only those selected for interviews will be contacted by a WMCHC representative.

Requirements

Requires the ability to communicate effectively, good organization skills, and detail oriented
Must be willing to learn and keep abreast on all billing guidelines and third party requirements
Experience with medical terminology, ICD-10-CM and CPT-4 coding and medical billing preferred.

Nice To Haves

Personable phone skills and computer experience preferred
Self-motivated, good at managing time effectively, and able to work well with others and independently

Responsibilities

Accurately and legibly codes super bills with ICD-10-CM and CPT-4 codes.
Enters proper information from superbills into the computer system.
Follows up with the physician office for information needed to complete data entry of bills. Reports ongoing issues with physician offices to coordinator.
Reconciliation of super bills, day sheets, computer reports and bank deposits.
Post payments, adjustments-recording information from explanation of benefits.
Payments/adjustments must be posted in a timely manner
All adjustments must be reviewed for appropriateness prior to posting.
Only adjustments on an explanation of benefit and within contract guidelines are to be posted without the coordinator's review.
Reconciliation of posting via computer and bank deposits
Timely filing of all secondary claims
Month-end process: All charges, payments and adjustments need to be entered by the second work day of the new month.
Follows up with insurance companies who request information or call regarding patient accounts or accounts greater than 60 days old.
Follows up with patient calls with a response to the patient within one working day.
Quarterly reviews of aged trial balance. Rebilling insurance/patient. Getting accounts ready for collections if needed.
Keeps abreast of new coding and insurance regulations and guidelines through seminars, newsletters, journals, internet.
Reviews billing guidelines to make sure data entry/insurance forms are correct.
Continuous daily operations of CHC.
Daily filing of CHC explanation of benefits.
Daily organization of incoming and outgoing mails.
Organization of 1500/319 forms, superbills, day sheets.
Performs other duties as assigned to support the efficient operation of the department.