Medical Billing and Coding Specialist

DEPARTMENT: Business Office

REPORTS TO: Administrator

JOB SUMMARY: This individual is responsible for billing, follow-up and collections of all insurance claims; maintaining correspondence with carriers, and documentation regarding same;  working with supervisor of the accounts receivable department to review problem accounts and identify necessary action to be taken.

EDUCATION AND EXPERIENCE:

• High School diploma or equivalent.
• Two years minimum experience in medical office; billing and collections experience preferred.

ESSENTIAL SKILLS AND ABILITIES:

• Excellent communication skills, written and oral.
• Strong organization skills with attention to detail.
• Excellent follow-up skills.
• Management of multiple tasks simultaneously.
• Work as a team player by demonstrating ability to work well and get along with co-workers.

RESPONSIBILITIES:

• Files, reviews, and follows up on insurance claims.
• Corrects and/ or writes appeals on denials.
• Follows up on delinquent insurance claims.
• Follows up on and corrects problems with billing.
• Assists patients with billing problems to include office, hospital, laboratory, and other office billing problems.
• Answer billing inquiries from patients, insurance companies, and attorneys via telephone and written correspondence.
• Assist with collection activities in an efficient manner.
• Obtain pertinent reports as requested.
• Apply knowledge of various insurance plans.
• Able to obtain an authorization or precert if required.
• Checks accuracy for insurance and demographics in registration.
• Is able to do all adjustments correctly.
• Must be able to answer billing questions correctly and make own sound decisions.

Other Duties assigned But Not Limited To:

• Help out Front Desk when called upon.
• Check insurance eligibility
• Check for authorizations for procedures
• Collect past due balances from patients
• Make payment plans when needed.
• Charge entry
• Payment posting