Medical Biller/Coder
Springfield, MA
General Description:
Provide front-line coding support to medical providers and other staff as appropriate. Develop and conduct training/education for providers and other clinical staff in accordance with FQHC policies and procedures.
Reports to: Billing/Coding Supervisor
Supervises: N/A
Salary/Status: Non-Exempt
Minimum Requirements:
- Certification as a Certified Professional Coder (CPC) or equivalent preferred.
- Experience with compliance, coding and billing issues, as well as experience in registering patients and entering/reconciling charges in a medical billing system as needed.
- Ability to establish and maintain effective working relationships with third party payers, individuals seeking assistance, and the general public.
- Professional in behavior and appearance
- Ability to read and decipher chart notes to validate, correct/ and/or apply appropriate diagnosis codes to claims as needed.
- Computer literacy and PC application skills
- Must possess the ability to interact positively with Supervisor and other staff members.
- Ability to type at least 35 WPM
- Ability to work within a team as well as work independently as need.
- Must be willing to work on site.
Principal Responsibilities and Duties:
- Responsible for outpatient physician/non-physician practitioner services through review of medical records/encounter forms or EHR records.
- Assign CPT codes, ICD-10 codes, HCPCS II codes based on documentation, payer requirements and billing policies.
- Compile, complete, verify, correct and/or register insurance information for new and existing patients.
- Provide financial counseling to patients for outstanding self-pay account balances.
- Process sliding scale applications and make necessary collection and discounting decisions.
- Resolve coding and reimbursement issues with providers, department managers and other clinical staff.
- Identify opportunities to reduce denials and enhance revenue.
- Concurrent coding/reviewing of coding of medical records.
- Assist in developing and implementing a billing compliance education/training program for new providers.
- Provide feedback and education regarding identified deficiencies to providers and clinical staff.
- Serves as a resource person to providers, departments and coding staff on problems dealing with compliance and billing issues, interpretation of coding issues/guidelines, and accurate coding.
- Maintains library of information/tools related to documentation guidelines and coding.
- Maintains confidentiality of account information.
- Concurrently codes, records and provides ongoing feedback to providers.
- Educates and trains physician and non-physician providers on proper medical record documentation in compliance with FQHC guidelines for billing of medical services. Education includes the Evaluation and Management coding requirements.
- Assist in providing feedback for developing program/communication mechanism to inform providers and clinical staff regarding new regulatory guidelines for billing and documentation compliance.
- Identifies problems related to assigned duties and proposes solutions.
- Performs other duties as assigned by the Billing/Coding Director, Supervisor or Team Lead.
- Work with Billing/Coding Supervisor, Team lead, EHR training staff and/or Super user(s) of EHR/EPM system, to become proficient in all aspects of learning and using the system correctly for your assigned job duties.
- Other related duties.
- Work billing & coding work queues and perform billing & coding duties accurately and efficiently while maintaining expected productivity levels.
- Management has the right to change or add to the job responsibilities at any time.
This position requires the ability to use a computer workstation with an operating keyboard.
From time to time, this position may require the ability to work long and arduous hours.