Medical Billing Specialist responsible for creating and sending insurance claims and patient statements for Pediatric Home Service. Analyzing payments, contacting patients, and utilizing billing systems for efficient service delivery.
About the role
- Medical Records Coder reviewing coding accuracy per guidelines and resolving insurance coding denials. Ensuring accurate reimbursement and collaborating with internal and external sources for documentation clarity.
Responsibilities
- Reviews codes for accuracy in accordance with coding rules and policies
- Responsible for system edit reviews and follows up on insurance coding denials for resolution
- Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assigns codes through medical record documentation
- Completes system edit reviews to make corrections before transmittal
- Troubleshoots problems that prevent claims from being released
- Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem
- Provides feedback for correction and follow-up
- May abstract data and review codes for accuracy
- Ensures accurate reimbursement based on guidelines and/or abstraction of provider documentation
- Responds to coding information requests and inquiries from various sources
- Consults with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete
Requirements
- High School diploma or equivalent
- 1 year Medical Coder experience required
- Associate's degree preferred
- Knowledge of ICD-10CM, CPT and HCPSC required
- Working knowledge of medical terminology and anatomy required
- American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred
- Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Medical Coder (CMC) from Practice Management Institute preferred
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
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Medical Billing Specialist responsible for creating and managing insurance claims in pediatric home health care. Collaborating with insurance companies and patients for billing resolutions.
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