Medical Coder

Brandywine Urology Consultants•New Castle, DE

16h•Onsite

About The Position

Responsible for all facets of medical billing coding audits of physicians and Advanced Practice Provider (APP). Assists Billing Specialists, Coders, and Patient Accounts Specialists in the ongoing operations of the Billing Department towards the achievement of Brandywine Urology Consultant's patient care and financial goals. Assist when needed to ensure the effective ongoing operations of the Billing Department. Responsible for providing cross coverage for the other Billing Specialists as required to ensure efficient and professional practice operations and maximum patient satisfaction.

Requirements

Requires a minimum of 5 years of experience preferably in a surgical subspeciality private practice setting.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Ability to write routine reports and correspondence.
Ability to speak effectively before groups of customers, employees, and/or physicians.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Knowledge of and experience on a computer in a Windows environment.
Experience with but not limited to spreadsheet software, word processing software and electronic medical record systems is necessary.
CPC certification.
Ability to handle patients in a pleasant, efficient and professional manner.
Knowledge of medical processes, procedures, lab and radiology tests and medications.
Background in medical terminology and general office procedures.

Responsibilities

Maintain all Physicians and & APP credentialling files including but not limited to: Christiana Care Health System Medical Staff Files, St. Francis Hospital Medical Staff Files, Delaware Outpatient Center for Surgery Medical Staff Files and all health insurance payors files.
Assist physicians and APPs in the maintenance of their professional licensure and CME requirements.
Maintain information regarding coding, insurance carriers, managed care networks and credentialing in an organized easy to reference format.
Review the physician's coding at charge entry to ensure compliance with Medicare guidelines and to ensure accurate and timely reimbursement.
Audit and provide feedback on a quarterly basis to Physicians and APPs on deficiencies in charting, opportunities for improvement related to documentation and charge capture.
Provide the quarterly audit report for the practice back to the Financial Operations Manager and COO.
Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to physicians and managers.
Responsible for all coding sets within Athena for services rendered and updating coding sets based on changes in regulation or identification of work completed by physician / APPs but not billed.
Input all charges related to the assigned physician's professional services into the practice management system including office and hospital charges in accordance with practice protocol with an emphasis on accuracy to ensure timely reimbursement and maximum patient satisfaction. All charge batches should balance in both number of procedures and total dollar prior to posting.
Post all payments, by line-item, received for physician's professional services into the practice management system including co-payments, insurance payments, and patient payments in accordance with practice protocol with an emphasis on accuracy to ensure maximum patient satisfaction and profitability. All payment batches must be balanced in both their dollar value of payments and adjustments prior to posting.
Post all credit and debit adjustments to patient accounts with strict adherence to the guidelines in the Procedure Manual.
File all charge, payment and adjustment batches in the appropriate format by batch date for quick reference.
Provide customer service both on the telephone and in the office for all patients and authorized representatives regarding patient accounts in accordance with practice protocol. Patient calls regarding accounts receivable should be returned within 2 business days to ensure maximum patient satisfaction.
Verify all demographic and insurance information in patient registration of the practice management system at the time of charge entry to ensure accuracy, provide feedback to other front office staff members and to ensure timely reimbursement.
Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills within five working days of receipt to achieve maximum reimbursement in a timely manner with an emphasis on patient satisfaction.
Submit primary and secondary insurance claims electronically each day and on HCFA semi-weekly to ensure timely reimbursement.
Process refunds to insurance companies and patients in accordance with practice protocol.
Proficiency with all facets of the medical practice management system including patient registration, charge entry, insurance processing, advanced collections, reports and ledger inquiry.
Maintain an organized, efficient and professional work environment.
Adhere to all practice policies related to OSHA, HIPAA and Medicare Compliance.
Other duties as assigned.