Health Care Certified Coder/Biller

In by FlatheadCHC

Website Flathead Community Health Center

Your Wellness Matters- Our Quality Health Team Includes You!

Job Summary: Provide technical support to support accurate medical documentation and coding for the purposes of high quality patient care and accurate reimbursement for medical, dental, and behavioral health claims. Works as a team member in the billing department to assist with administrative and technical support duties relating to management of third-party billing activities and related work as required.

Essential Functions (Major Duties or Responsibilities): These duties are the essential functions and are not all-inclusive of all duties that the incumbent performs.

·         Assigns code to diagnoses and procedures using ICD and CPT codes

·         Ensures codes are accurate and sequenced correctly in accordance with       government and insurance regulations.

·         Reviews and verifies documentation to support diagnosis, procedure, and treatment results.

·         Follows up with providers on any documentation that is insufficient or unclear.

·         Provides information for the preparation of documents for legal inquiries and/or litigation.

·         Works as a team with the other billing staff to complete billing duties.

·         Identifies and bills secondary or tertiary insurances.

·         Researches and appeals denied claims.

·         Enters third party payment into the data system as appropriate.

·         Determines Medicaid and other insurance eligibility.

·         May assist patients in understanding billing charges and developments payment plans as necessary.

·         Maintain knowledge of primary code classifications (CPT, ICD-10) and third party billing requirements and acts as a resource to providers for billing and coding issues.

·         Performs related work as required.

·         Takes the initiative to increase knowledge needed to effectively process claims and bills. This may include course-related studies, attending workshops as well as other means of knowledge acquisition.

·         Ensures the confidentiality of patients’ protected health information.

Non-Essential Functions:

Incumbents may be requested to perform functions relevant to the position but not listed above.

Physical Demands and Working Conditions:

Work is performed in an office and clinic environment and requires typical range of motion and physical agility associated with the operation of office equipment.

Supervision Exercised:

This is a non-supervisory position.

Knowledge, Skills, and Abilities:

·         Knowledge of coding in an ambulatory setting.

·         Knowledge of Medicaid, Medicare, and third party payment sources.

·         Knowledge of medical billing systems and electronic health records.

·         Knowledge of medical terminology and anatomy.

·         Knowledge of debt collection practices and insurance guidelines.

·         Knowledge of contemporary computer usage including word processing, spreadsheets and databases.

·         Skill in communication with patients and healthcare organizations.

·         Skill in the use of various office machines with a high level of proficiency.

·         Ability to communicate effectively the details of medical coding by offering assistance to other billers; informing co-workers of changes within the system.

·         Ability to perform complex clerical work.

·         Ability to effectively deal with administrative detail.

·         Ability to make mathematical computations.

·         Ability to act with initiative and good judgment and to make sound independent fiscal and administrative decisions.

Education and Experience:

·         High school graduation or equivalent, preferably an Associates Degree in medical coding.

·         Possesses a certification in Medical Coding from an accredited program.

·         Minimum 1-3 years’ experience in healthcare coding and billing, preferably within an FQHC.

Benefits: Benefits: 401(k) , Dental insurance, Disability insurance , Flexible spending account , Health insurance, Health savings account, Life insurance, Paid time off

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