Credentialing Specialist
March 21, 2016
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Certified Medical Coding and Billing

Responsibilities

  • Follow protocol to ensure appropriate billing and payment cycles, and accurate and timely billing occur in accordance with established internal and carrier requirements;
  • Follow appropriate procedures for follow-up on third-party approvals;
  • Maintain appropriate internal controls over accounts receivables/cash receipts, and monitors charge posting, billing, and collection operations for compliance with established policies, regulations, procedures, and standards;
  • Review charge tickets and resolves problems concerning the recording or provision of services rendered which impact on ability to collect charges;
  • Confer with clients regarding delinquent accounts, special adjustments, and/or write-offs;
  • Prepare and maintain required records, files, and reports on billing and financial activities; and
  • Ensure compliance with Precision’s Employee Handbook, state and federal laws.

Requirements

  • 2+ years of successful work history as a Medical Biller, Medical Coder or Medical Assistant;
  • Experience in the use of EHR and medical billing software, Epic, Nextgen, Allscripts, LSS, Meditech, Intergy, Mysis and/or eClinicalWorks a plus;
  • Full understanding of client encounter forms
  • Use extensive coding knowledge to append specific CPT and/or ICD-9 or 10 codes to services rendered based off encounters received or documentation
  • Add CPT/ICD-9/10 codes into PM system
  • Review/print daily recap reports from coding batches as deemed necessary
  • Maintain coding questions/send backs to clients; follow up as necessary for appropriate billing
  • Update client master log on a daily basis
  • Audit coding batches as deemed necessary by manager
  • Ability to code all office visits for all specialties
  • Send appropriate client communications on a daily/weekly basis as needed
  • Appropriate knowledge of CMS guidelines and the ability to apply accurately
  • Extensive knowledge of ICD-9-CM (ICD-10 preferred), CPT-4, HCPCS coding conventions
  • Extensive knowledge of anatomy and physiology, as well as medical terminology
  • Excellent communication skills
  • Ability to set priorities and meet deadlines while working independently
  • Must have one of the following certifications/licenses: CPC, CCS, RHIA, RHIT
  • Extensive knowledge of appropriate billing and payment cycles for medical accounts;
  • Extensive knowledge of medical terminology and coding;
  • Knowledge of operational characteristics and procedural requirements of third party medical insurance payors;
  • Strong interpersonal and communication skills, including the ability to communicate effectively with a wide range of physician practices and their patients;
  • Must be process and detail oriented;
  • Ability to multi-task, as well as organize and prioritize work assignments; and
  • Ability to work independently and complete assignments timely and accurately.

Job Type: Full-time