Medical Biller/Coder

Desert Shores Pediatrics

Billing Specialist Position Description

A key position in the revenue cycle, manages the claims process, including accurate and timely claim creation, insurance inquiries/correspondence and follow-up and correspondence with providers. Will assist in the clarification and development of process improvements and ensure payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues.

Principal Accountabilities:

. Prepare and submit clean claims to third-party payers either electronically or by paper

. Maintain relationship with clearinghouse, including appropriate follow-up on support issues

. Coordinate the process of patient eligibility through various third-party sources

. Coordinate collection process and track current collection accounts

. Manage monthly statement process

. Work with reception staff to ensure appropriate collection of co-pays, deductibles and self-pay fees

. Coordinate and administer billing policy and procedures

. Patient collection calls and reporting.

. Handle patient inquiries and answer questions from clerical staff and insurance companies

. Identify and resolve patient billing issues

. Denial and insurance follow-up management

. Issue adjustments, correct and or/rebill claims to third-party payers

. Post insurance checks/ EOB’s with accurate adjustments, transfer of responsibility and refunds as necessary

. Ensure coding is compliant and up to date

. Maintain strictest confidentiality, adhere to all HIPAA guidelines/regulations

. Coordinate provider enrollment in all commercial, state and federal insurance programs

. Correspond with and provide updates to insurance companies

. Monitor highest volume codes, do comparison reports on payers

. Watch for new codes and know what’s allowed within each payer's contract

Job Requirements:

. Knowledge of insurance guidelines, including HMO/PPO, Medicaid and other payer requirements and systems

. Knowledge of medical billing, CPT and ICD-10 Coding, collection practices

. Ability to complete multiple tasks effectively

. Ability to work both independently and as part of a team

. Capable of making timely, independent decisions

. Problem-solving skills to research and resolve discrepancies, denials and appeals

. Excellent organization skills

. High school diploma or equivalent

. Billing and coding certificate preferred

Experience:

. Previous medical billing in a physician office or facility setting

. Experience working with medical payers including commercial and Medicaid

. Working knowledge of CPT and ICD-10 coding systems. Coding certification preferred

Physical and Cognitive Requirements:

. Able to lift 25 pounds

. Able to view computer screen for long periods of time

Job Type: Full-time

Pay: $20.00 - $24.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Medical billing: 1 year (Required)

Work Location: In person

Salary : $20 - $24