Coding Specialist Jobs

About The Position

Requirements

• Reads, speaks, understands and writes proficiently in English.
• Works independently and is self-directed.
• Works effectively in a team environment.
• Problem-solves with creativity and ingenuity.
• Organizes, prioritizes, and coordinates multiple activities and tasks.
• Works with initiative, energy and effectiveness in a fast-paced high-pressure environment.
• Produces work in high quantity and quality.
• Remains calm and effective in high pressure and emergency situations.
• Use of multi-line telephones and other office machines.
• 10-Key: 150 kpm with a 97% accuracy rate.
• Keyboarding: 35 wpm with a 97% accuracy rate.
• Knowledge of medical terminology.
• Knowledge of HIPAA regulations and compliance.
• Ability to make decisions regarding sensitive information.
• Proficiency in the use of Microsoft Office applications; Word, Excel and Outlook.
• Customer service-related experience working with the general public (1 year).
• Data entry experience (1 year).
• Working with insurance/billing in a healthcare setting/insurance organization.
• Healthcare information systems, such as electronic health record and practice management systems experience (1 year).
• Working with private and/or government third party reimbursement.
• High school graduate or equivalent.

Nice To Haves

• Knowledge of dental terminology.
• Knowledge of healthcare revenue cycle functions, including documentation, coding, and billing guidelines.
• Knowledge of government rules and regulations as it pertains to compliant billing practices, using National Correct Coding Initiative (NCCI), and third-party payer rules.
• Bilingual skills.
• Graduate of an accredited Medical Billing Certificate program.
• ICD-10 coding experience (1 year).
• CPT-4 coding experience (1 year).
• CDT-5 coding experience (1 year).
• Working with low income, multi-ethnic populations.
• Call Center experience (1 year).
• Experience working in a multiple provider practice.
• Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) or Coding Specialist (CCS) certified by the American Health Information Management Association (AHIMA).

Responsibilities

• Takes and responds to a high volume of calls and emails each day, providing required information to external agents and patients.
• Research and reply to patient messages through the Portal or other communication methods.
• Monitors patient accounts voicemail and returns messages to patients and callers.
• Verifies insurance coverage and submits claims to insurance companies.
• Serves as resource for staff on all aspects of insurance programs, discount applications, payment plans, and patient payment processing.
• Communicates effectively and respectfully, both in verbal and written form, with patients, providers or clinical staff to obtain missing or incomplete information.
• Answers or appropriately refers billing questions.
• Processes discount fee adjustments and enters tracking data into a discount fee database.
• Researches patient questions regarding accounts/statements and initiates appropriate adjustments and/or resubmission of claim(s).
• Adheres to established quality and quantity standards of the department, including participating in quality reviews for performance improvement.
• Researches and reconciles patient credit balances and initiates refund requests.
• Performs A/R resolution.
• Assists patients in setting up payment plans and completes payment plan contracts.
• Ensures compliance with records management guidelines by scanning various documents, including, but not limited to, statement verifications, collections, OB billing and invoices.
• Assists with dental and medical charge entry.
• Inputs billing information into Provider One and other carrier portals for primary and secondary billing, coordination of benefits and claim follow up and resolution.
• Assists with cash posting and reconciliation of deposit logs.
• Assists with processing mail returns.
• Assists with posting unapplied payments, researching credits and processing patient refunds and rolling accounts to collections.
• Adheres to attendance standards in order to perform the job functions for daily operations and/or continuity of patient care.

Benefits

• health insurance (medical/dental/vision)
• up to 120 hours of vacation time pro-rated by FTE every 12 months
• paid sick leave
• 10-paid holidays
• 403(b) Safe Harbor retirement plan with employer match
• disability and life insurance
• $0.75/hour for those who test proficiently in a second language