Coding Specialist
Description:
Job Description
Description:
Under supervision of the RCM Billing & Coding Manager serve as a Coding Specialist (coder), responsible for reviewing claims activity for proper coding in the revenue cycle billing and claims functions. This position may be required to travel to the practices within the Balance Health Network. This is a remote position but the person in this role will be required to work 7:30am-4:00pm PST, preferably someone in the pacific time zone.
Duties and Responsibilities
Responsible for billing, coding, and resolving encounter forms from the clinics, surgery centers, and hospitals related to Balance Health
Identify and present improvement recommendations based on gathered knowledge and experience while working directly with the providers’ documentation and productivity
Assist in monthly audits
Determine and assess patient records, review accounts receivable activities, and collect payment
Responsible for communication with clinicians on a regular basis
Responsible for coding and billing accuracy to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices
Responsible for complete and accurate Patient Demographic Information
Follow up on rejected and/or unpaid claims according to standards
Regulatory Billing Practices Audit & Analysis
Determine accuracy of Insurance Payments and follow up on discrepancies
Run and build reports as required
Review and appeal unpaid and denied claims
Monitor A/R and Collections
Identify and bill secondary or tertiary insurances
Respond to patient and/or insurance companies billing questions
Execute work on assigned claim worklists, AR worklists, reporting, or projects
Communicate trends and root issues through proper lines of reporting
Provide support to medical providers and practice specialists as appropriate regarding coding compliance documentation
Meet productivity and Key Performance Indicator standards
This position may also require light travel to the practices (POV mileage will be reimbursed)
Other duties as assigned
Open to candidates in Arizona, California, Colorado, Florida, Hawaii, Illinois, Michigan, Nevada, North Carolina, South Carolina, Texas, Virginia, and West Virginia.Requirements:
Ability to use independent judgment and to manage and impart confidential information
Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation
Knowledge of all Insurance guidelines especially Medicare and Medicaid according to standards
Ability to communicate logically and clearly both orally and in writing
Education and Experience
High school diploma or equivalent
Minimum of 3 years’ experience interpreting insurance explanation of benefits
Minimum of 3 years’ experience with medical claims, billing, payment posting and insurance collections
Certified Professional Coder (CPC) required
About Balance Health
Balance Health empowers people to live full lives by helping them improve and maintain mobility. We do this by bringing together leading podiatrists, orthopedic surgeons, vascular surgeons, and physical therapists and providing them the tools and resources necessary to deliver exceptional patient care. This mission has made us the fastest growing lower-extremity focused Physician Practice.
Full-time
Fully remote