Processes and submits medical claims, verifies coding and documentation, balances postings, enters cash receipts, resolves denials, collects patient balances, and answers billing inquiries. The role requires accurate use of CPT and ICD-10 codes, payer knowledge, timely claim processing, and communication with providers and office staff.
Job Summary & ResponsibilitiesPreferred Qualifications
*An active Certified Professional Coder certificate is required to be considered for this role*
Schedule: Monday-Friday 8am-5pm
Pay Range: $22-25 per hour, dependent on experience
SUMMARY OF JOB DUTIES:
The person handling this position is responsible for correcting, completing, and processing and collecting payment for claims of all payer codes.
ESSENTIAL JOB FUNCTIONS:
- Daily key punching into computer when needed to assure accuracy of billing for all services rendered in patients account to be completed within 24 business hours of the completed service.
- Ensure completion of documentation and coding on the EMR when needed on charges entered in patient's accounts for a correct and complete billing claim.
- Monthly input of all ancillary services including Nursing Home and Home Health charge encounters into the computer to assure accuracy of services rendered.
- Daily review of all postings before claim submission.
- Daily closing of batches and balancing of money posted.
- Enter cash receipts if needed and assure correct allocations, distribution in accordance with the established protocol.
- Responsible for submitting all electronic claims.
- Responsible for answering Billing Phone calls and providing exceptional customer service to patients with billing related questions.
- Resolving claim denials and issues with claim payment in a timely manner.
- Working to collect patient balances in a timely manner.
- Effectively communicate with providers on claim documentation for charges submitted.
Knowledge/Skills/Abilities:
- Ability to work under pressure.
- Ability to handle multi-functions/multi-tasks.
- Ability to problem solve.
- Pay attention to detail.
- Understanding of community-based organizations.
- Ability to communicate with the medical/dental staff and Office Managers.
- Some knowledge of bookkeeping and office functions.
- Some knowledge of CPT and ICD10 codes.
- Ability to work proficiently and efficiently on a timely manner.
- Knowledge of all payer codes.
- Knowledge of all programs offered by NHSI.
MINIMUM REQUIREMENTS
- High School Diploma or Equivalent
- CPC Certification required
- At least 3 years of billing and coding experience (outpatient/medical practice coding experience preferred)
- (2) Training or background in ICD-10 / CPT codes.
- Knowledge of medical terminology and billing practices.
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