Billing and Coding Specialist

REPORTS TO: Billing Manager                                                                                  FLSA STATUS: Full Time-Non-Exempt

SCHEDULE: Onsite 

POSITION SUMMARY: Responsibilities for all duties involved in billing and coding for medical and mental health services provided for Revive Ministries Inc. and Revive Life House (Revive) facilities and programs. These duties apply to all Revive facilities operated by Revive Ministries, Inc. This position will collaborate with other departments to ensure accurate billing and coding for all billable services.

GENERAL RESPONSIBILITIES:

1. Compile, audit and process all billing of Medical &/or Behavioral Health services offered through EMR.


2. Compile and reconcile all payments received for Medical &/or Behavioral Health services and provide monthly payment reports to the billing supervisor.


3. Provide the Billing Manager with weekly billing reports.


4. Monitor and maintain working knowledge of all providers’ information, to ensure accurate billing and coding requirements.


5. Verify claim status, submit corrected and/or claim reconsiderations/appeals for denied claims Keep records for submissions and follow-up.


6. Work closely with the Client Benefits Coordinator for accurate benefit verification.


7. Respond in a timely manner and assist with audits from Managed Care Organizations.


8. Enter fees for self-pay clients monthly.


9. Comply with all state, federal and accrediting regulations regarding billing and coding in a Behavioral Health facility.


10. Must adhere to strict patient confidentiality and all HIPAA laws.


11. Become knowledgeable of all Revive programs and services, to better understand the services for which you will be billing and reconciling.


12. Become knowledgeable of all Revive Life House rules, policies, and procedures.


13. Develop and maintain positive relationships with insurance vendors to create reciprocity in services.


14. Attend required departmental and/or agency meetings as required by the agency.


15. Assist with medical record requests.


16. All other duties as assigned.

BACKGROUND/ EDUCATION:

1. Current certification in Medical Billing and Coding or commensurate experience 


2. Must have a minimum of one (1) year experience with Medicaid billing/coding.


3. Excellent written and oral communication skills, as well as the ability to work and meet deadlines in a fast-paced environment.


4. Strong computer and customer service skills.


5. Prior experience working with billing software is preferred.


6. Must have dependable transportation.

QUALIFICATION REQUIREMENTS:

Must have knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]; computer applications/software to include Microsoft Office programs/ MS Outlook (e-mail), Electronic Medical Record (EMR)and internet familiarity. 

This position will work with health care providers to help ensure appropriate and consistent administration of plan benefits through collecting clinical and medical services information required to submit accurate billing and billing codes. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the job.  

SKILLS REQUIRED:

1. Excellent organization and time management skills with ability to work independently.


2. Effective verbal and written communication skills. 


3. Ability to maintain effective interpersonal relationships.


4. Critical thinking, independent judgment, and confidence to carry out decisions.


5. Knowledge of, and ability to apply state, federal and local regulations and laws governing medical coding   and billing.

WORKING CONDITIONS:

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Must be able to sit, stand, bend, reach overhead and lift up to 10 pounds; travel outside of the office and/or attend meetings both during and after normal work hours, on and off-site.  Exerting up to 10 pounds of force occasionally or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects. May involve walking or standing for brief periods of time.  Requires about 6 hours of sitting and no more than 2 hours of standing or walking in an 8-hour workday. No significant stooping is required.

Environmental Conditions:

The employee will work indoors in a business office setting with central heating and air conditioning. 

Mental Demands:

There are several daily deadlines associated with this position, which may cause significant levels of stress for some individuals.  The position must deal with the staff and insurance representatives daily on a variety of issues. 

AT-WILL EMPLOYER STATEMENT:

Revive Ministries Inc. (Revive) is an At-Will employer. This means that regardless of any provision on this form, the company or employee may terminate the employment relationship at any time, for any reason, with or without cause or notice.  Nothing in this job description or in any document or statement, written or oral, shall limit the right to terminate employment at-will.  No officer, employee or representative of the company is authorized to enter into an agreement, express or implied, with any employee for employment for a specified period unless such an agreement is in a written contract signed by the CEO or COO of the company. 

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT:

Revive Ministries Inc. (Revive) is an Equal Opportunity Employer, in compliance with federal, state, and local laws prohibiting discrimination.  No person shall be discriminated against in employment, training, promotions, transfers, rates of pay, layoffs, any form of compensation or any term or condition of employment on the basis of race, sex, color, religion, national origin, age, marital status, disability, tobacco use, gender identity, genetic information, military status, pregnancy or childbirth, status as a smoker or non-smoker, veteran status or any other protected class under federal, state or local law.