Certified Coder Medical Billing Specialist

Job Description

ESSENTIAL JOB FUNCTIONS:

Essential functions of the job include, but are not limited to, medical and dental insurance understanding of coordination of benefits, claims processing, and follow up. Utilizing a computer for data entry, conducting research, electronic communications, attending meetings, drafting and distributing reports, interacting with others, reconciling data, creating and updating spreadsheets. Communicating with others is an essential job function.

SALARY: $58,700-$73,300

***MUST BE LOCATED IN OHIO***

BENEFITS:

PTO

Vision

Dental

Health

401k

Sick time

MAJOR AREAS OF RESPONSIBILITIES:

Review Coding, Auditing, and billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.

Prepare and submit clean claims to various insurance companies to include both paper and electronic.

Extensive insurance follow-up and working knowledge of the appeals resolution process is required.

Working in EMR system's workques to process claims per coordination of benefits

Review billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.

Responsible for contacting insurance companies and navigating insurance websites in order to secure and expedite payments.

Assisting in payment research in a timely and accurate manner.

Answer billing inquiries from patients, clerical staff and insurance companies.

Identify and resolve patient billing complaints.

Assist with patient inquiries for revenue department

Review assigned workques daily to ensure claims are timely

Evaluate patient’s financial status and rebill claims in conjunction with team and third party billing company

Follows and reports status of delinquent accounts.

Perform various collection actions including contacting patients by phone,

Correcting and resubmitting claims to third party payers as appropriate in conjunction with Epic/Ochin

Participate in educational activities and attends monthly staff meetings.

Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Perform other duties for Finance Department.

EDUCATION/LICENSURE:

· High school diploma, Associate’s preferred

· Medical billing certification or equivalent education on the job, formal education required.

· AAPC or other appropriate Professional Coding Certification required

· CPC, CPA, CPMA or relevant certification

KNOWLEDGE, SKILLS, ABILITIES AND OTHER QUALIFICATIONS:

· Financial management, payment processing, and/or accounting experience, and/or formal training or certification preferred

· Must have strong knowledge of CPT and ICD-10 codes and basic medical terminology skills.

· Experience with EMR (Electronic Medical Record) and medical billing software preferred.

· Knowledge of third-party operating procedures and practices, with the ability to read and process EOB’s.

· Ability to travel to multiple clinics in Ohio for trainings and meetings as needed.

· Proven record of accomplishment of exceeding goals; evidence of the ability of consistently make good decisions through a combination of analysis, experience and judgment; abilities in problem solving, project management and creative resourcefulness.

OTHER INFORMATION:

Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA

ORGANIZATION INFORMATION:

Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.

Full-time