Billing and Coding Specialist

Description

Axiom Care is a fast-paced, rapidly growing substance abuse treatment and sober living housing provider with locations in the Phoenix metro area and Apache Junction. We primarily serve low-income and justice-involved individuals who are seeking to change their life for the better. We achieve this by offering multiple levels of care along with medical services, evidence-based professional counseling, case management, housing assistance, employment assistance, and more. 

Job Summary

We are seeking a knowledgeable Certified Billing and Coding Specialist with full-revenue cycle experience in both front-end and back-end. The Billing and Coding Specialist is responsible for a variety of lifecycle claim management functions including timely claim submission, collection, and reimbursements. Additionally, the Specialist is also responsible for reconciling rejected claims from EMR and Clearinghouse vendors, including obtaining missing information, aging claims/follow-up, and limited charge entry. Also, ability to work in a fast-paced environment.

Duties/Responsibilities

• Proficient in assigning accurate medical codes for diagnoses, procedures, and evaluation and management services according to the appropriate classification system

• Maintain knowledge of anatomy, physiology, and medical terminology to ensure that diagnoses and services are properly coded

• Review all notes for accuracy and completeness

• Obtain missing information from providers and clinical staff members

• Identify all chargeable items within each progress note and ensure proper CPT/HCPCS codes for each item

• Research any unpaid claim and make corrections needed based on Payer.

• Responsible for processing any updated information for claims to reprocess and ensure timely payment.

• Check Eligibility, Billing and Collections

• Correctly complete claims daily for outpatient and in-patient services as designated by CMS

• Accurately enter all necessary modifiers

• Review patient claims for demographic and coding accuracy and completeness; obtain and enter any missing demographic information

• Prioritize tasks so that the most important tasks are completed first

• Attend meetings and training as directed

Requirements

Required Skills/Abilities: 

• Excellent verbal and written communication skills. 

• Excellent interpersonal and customer service skills.

• Excellent sales and customer service skills.

• Excellent organizational skills and attention to detail.

• Excellent time management skills with a proven ability to meet deadlines.

• Strong analytical and problem-solving skills.

• Ability to prioritize tasks and to delegate them when appropriate.

• Ability to function well in a high-paced and at times stressful environment.

• Proficient with Microsoft Office Suite or related software.

• Knowledge of CPT, HCPCS, and Modifier experience required.

Education and Experience

• High school diploma or GED required.

• Minimum 18+ months of experience with billing medical claims.

• Minimum 18+ months experience performing healthcare reimbursement, behavioral health insurance/billing or related work.

• Experience working in a Hybrid environment preferred.

• Equivalent combination education, training, and experience.

• Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCS-P) credential required.

Required Skills/Abilities: 

• Analytical Thinking - Uses logical reasoning to process, break down, and work through a situation or problem to arrive at an outcome. 

• Decision Making/Problem Solving - Breaks down problems into components and recognizes interrelationships; makes sound, well-informed, and objective decisions. Compares data, information, and input from a variety of sources to draw conclusions; takes action that is consistent with available facts, constraints, and probable consequences. 

• Communication - Clearly conveys and receives information and ideas through a variety of media to individuals or groups in a manner that engages the listener, helps them understand and retain the message, and invites response and feedback. Keeps others informed as appropriate. Demonstrates good written, oral, and listening skills.

• Collaboration and Teamwork - The ability to function effectively as a member of an inter-professional team that includes behavioral health and primary care providers, consumers, and family members. Participates as an active and contributing member of a team to achieve team goals. Works cooperatively with other team members, involves others, shares information as appropriate, and shares credit for team accomplishments.

• Managing Work - Shows ability to plan, schedule, direct work of self and others; balances task requirements and individual abilities; organizes materials to accomplish tasks; sets challenging yet achievable goals for self and others.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.

• Must be able to lift up to 15 pounds at times.