Bcbs Coding Jobs in Rochester, NY (NOW HIRING)

Position Summary

Facilitate the day-to-day billing function for physician, facility, and anesthesia services. Communicate courteously and effectively with staff, patients, insurance providers, software representatives, and others as required. This role plays a key part in assuring reimbursements are timely and accurate while supporting efficient financial and administrative operations.

Qualifications

• High school diploma required; Associate degree preferred
• Minimum 3+ years of hands-on billing experience
• Basic knowledge of ICD-10/CPT coding preferred
• Proficient in Microsoft Office applications
• Experience with Open PM, 4D, and/or SIS preferred
• Strong problem-solving and analytical skills
• Ability to communicate professionally and effectively verbally and in writing
• Ability to interact with employees, vendors, patients, and insurance representatives in a professional manner
• Ability to work independently and collaboratively in a fast-paced, high-volume environment with emphasis on accuracy and timeliness
• Ability to perform mathematical computations such as percentages and fractions

Duties and Responsibilities

Billing & Insurance Functions

• Verify insurance eligibility and benefits for future appointments for functional services
• Review copays and update schedules to assist front desk collection efforts
• Obtain referrals and prior authorizations required for office visits, outpatient procedures, and radiology services
• Prepare estimates of patient out-of-pocket costs based on procedures and insurance benefits
• Enter new procedures and surgeries into EMR systems and update fees annually according to BCBS fee schedule changes or management direction
• Submit electronic and paper insurance claims accurately and timely
• Investigate and reconcile insurance claim denials
• Post cosmetic payments, patient copays, and insurance payments in Open PM, 4D, and SIS systems
• Prepare, distribute, and follow up on patient billing statements
• Identify and resolve patient billing concerns and complaints
• Perform collection activities including contacting patients, correcting and resubmitting claims, and preparing accounts for collection agency processing
• Process all patient credit card refund requests
• Ensure cosmetic surgeries are paid in full one week prior to surgery and communicate balances to patient consultants
• Communicate with providers to clarify medical record documentation for accurate coding and billing purposes

Administrative Responsibilities

• Assist with Surgery Center scheduling
• Perform general office duties including copying, scanning, faxing, and filing
• Maintain prompt and regular attendance
• Support departmental operations and complete additional duties as assigned by management

Physical Setting

Office environment

Physical Demands

• Prolonged periods of sitting
• Occasional standing and walking
• Ability to lift and carry items up to 25 pounds

Travel Requirements

None

Benefits

• Medical Insurance
• Dental Insurance
• Vision Insurance
• FSA – Flexible Spending Account
• HSA – Health Savings Account
• Life Insurance
• Paid Time Off and Holidays
• Employee Discounts
• Additional employee benefit programs as applicable

Note: All duties and responsibilities stated are essential job functions. Employees may be required to perform additional job-related duties as assigned by management.

It is the policy of Rhino Administrative Services, LLC to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information, or any other protected characteristic under applicable law.