Analyze patient charts carefully to know the diagnosis and represent every item with specific codes.
Collect health information as documented by medial provides and code appropriately. Consult with providers for further classification of items on patient charts to avoid misinterpretations.
Maintain certification by staying up to date on new coding rules and regulations.
Conduct audits of patient charts to verify appropriate coding was applied and review with physicians for training purposes.
Review of patient medical charts to identify proper coding for denied claims.
Collect and distribute coding related information and billing issues.
Handle claims denial follow-up.
Perform billing functions as it pertains to coding.
Assist Clinic staff with patient coding and related procedures
Collaborate with supervisor to increase revenue and system efficiency
Communicate all outstanding billing required from Providers on a timely basis.
Maintain confidentiality in accordance with RHC policy, HIPAA and any other applicable regulatory requirements.
Exemplify the RHC mission through a personal example of excellent service to patients, visitors and coworkers.
Attend regularly scheduled staff meetings
Other duties as assigned
Requirements
Required Education, Certification, Experience and Skill:
Business school training in medical billing preferred or comparable two years
Current CPC or HCPCS Certification. ICD-10 certification a plus
Have demonstrated knowledge/experience with medical terminology, claims processing, and medical coding.
Have a thorough understanding of managed care concepts including HMO, MCE and capitation
Have a solid understanding of Medicaid and Medicare.
Have a solid understanding of the complete billing cycle.
Dental billing experience a plus.
Optometry billing experience a plus.
Proficient with MS Office and Practice Management Systems [ECW preferred].
Strong interpersonal and communication skills with an ability to work effectively with a wide range of people, supervisors, co-workers and vendors.
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