Billing Coding Specialist Certified

JOB TITLE: BILLING CODING SPECIALIST - CERTIFIED

DEPARTMENT: Administrative

SUPERVISOR: Finance Director

EXEMPT/NON-EXEMPT: Non-Exempt 

SUPERVISES: N/A

JOB SUMMARY:

As Billing Coding Specialist, using the established medical codes, transcribe patient history to be used by both health care providers and insurance companies. The Billing Coding Specialist updates the codes for services received and translates each code as it applies to the patient’s healthcare insurance provider; prepares the claims document and submits, organizes, and tracks all insurance claims making sure that the payment is received. In addition, the Billing Coding Specialist deals with customers in terms of answering questions, arranging payment plans, and handling collections if a payment never materializes.

GENERAL REQUIREMENTS

Follow Willapa Behavioral Health Service Excellence Standards / Code of Ethics and Policies and Procedures

1. Adhere to rules of confidentiality.
2. Respect and accommodate a diverse population.
3. Maintain appropriate boundaries with clients and staff.
4. Work on-site as necessary or remotely using telehealth technology as determined by management.

ESSENTIAL FUNCTIONS:

1. Read and analyze patient records; obtain clarification on notes and charts to ensure accuracy.
2. Ensure all records are properly signed off on.
3. Assign the correct codes to all diagnoses and services.
4. Enter and organize the codes into the management software.
5. Be familiar with ICD-9-CM, ICPM, DSM-IV, and CPT-HCPCS coding systems; using the codes, bill the insurance providers.
6. Track patient data over multiple visits.
7. Manage detail, specifically coded information.

JOB REQUIREMENTS:

MINIMUM QUALIFICATIONS

1. High school degree
2. Well organized: have the ability to formulate and follow efficient working procedures and guidelines.
3. Experience with claims processing in a medical or mental health environment.  
4. Experience billing and processing claims with public and private insurance.    
5. Effectively explain all charges to patients and their families and remain professional and empathetic in the face of dispute over charges and payment.
6. Technologically savvy: up to date with technological developments in the field, especially as it relates to software developments.
7. Excellent verbal and written communication skills, computer proficiency to document in the electronic medical record (EMR) and utilize telehealth and Microsoft office suite. 
8. Undergo and pass criminal background check upon initial employment and any subsequent checks required by the agency.
9. Meet requirements of agency’s drug free workplace policy.
10. Excellent customer service with a client focus.
11. Able to sit, stand and move for long hours at a time and lift up to 25 pounds.
12. A valid driver’s license and reliable vehicle.
13. Able to drive in daylight, darkness, and typical Northwest weather conditions.
14. Flexible to fill-in shifts if needed. 
15. Other duties as assigned.
16. Meet the current Washington health care vaccination requirements for health care workers.

REQUIRED QUALIFICATIONS

1. Coding Certification by an Accredited organization and/or Associates Degree