Medical Coder/Biller (On-Site Opportunity)

Surgery Partners Careers•Wilmington, NC

1d•Onsite

About The Position

The Coder/Biller will determine the appropriate CPT codes and Diagnosis codes for all surgical procedures performed in a Multiple Specialty Ambulatory Surgery Center. Candidate should be able to issue claims via electronic and/or paper billing to facilitate timely billing and days in AR benchmarks; track and correct electronic claims submission rejections/errors; provide operative reports and any medically necessary information to include surgeon’s office notes, pathology reports, etc. Have an extensive understanding of all Payers to include Medicare, Medicaid, Commercial Carriers and private Carriers. Coder will follow Medicare Rules and regulations and will update billing procedures to accommodate these changes and keep current with insurance contract rates and all billing policy changes. Work directly with Collectors and Accounts Receivable to timely and accurately submit all insurance claims. In addition, this individual will help assign self-pay and cosmetic facility charges based on company policy. This staff member will also assist with Insurance Verification to ensure that Authorizations and Approvals for procedures performed are approved prior to the Date of Service.

Requirements

2-5 years prior business office experience relating to surgery centers, hospitals and/or physicians' office
Proficient in Patient Accounting Systems
Certified or Non-Certified Medical Billing specialist
Extensive knowledge of CPT/ICD-9 and Diagnosis coding
Ability to read and interpret EOB’s
Stays current on all Medicare Rules and Regulations
Extensive knowledge of AR Management (billing, coding, and collections)
Payor Contract Management
Issue claims via electronic and/or paper billing to facilitate timely billing and days in AR benchmarks

Responsibilities

Determine the appropriate CPT codes and Diagnosis codes for all surgical procedures
Issue claims via electronic and/or paper billing
Track and correct electronic claims submission rejections/errors
Provide operative reports and any medically necessary information
Follow Medicare Rules and regulations and will update billing procedures to accommodate these changes and keep current with insurance contract rates and all billing policy changes
Work directly with Collectors and Accounts Receivable to timely and accurately submit all insurance claims
Assign self-pay and cosmetic facility charges based on company policy
Assist with Insurance Verification to ensure that Authorizations and Approvals for procedures performed are approved prior to the Date of Service
Maintain continuing education based on the different carriers coding guidelines, rules, and regulations
Complies with required timelines to close the period in the automated billing system
Maintain regular attendance habits
Other duties as assigned