JOB TITLE: Full Cycle Biller, Charge Entry Coding/Auditing
FLSA STATUS (Exempt/Non-Exempt): Non-Exempt
SUPERVISION RECEIVED: Reports to Billing Manager
SUPERVISION EXERCISED: NONE
GENERAL STATEMENT OF DUTIES
Full Cycle Biller, Charge Entry Coding/Auditing supports the billing department by assisting with managing incoming and outgoing charges and payer responses while verifying and ensuring accuracy and completeness for a complete billing cycle.
ESSENTIAL FUNCTIONS
โข Utilizes ICD.10, CPT, amp; HCPCS coding principles to review provider charges for accurate documentation and submission of billing.
โข Utilizes knowledge of CPT, HCPCS amp; ICD.10 coding to assist in onboarding new services.
โข Utilizes knowledge of payer medical and billing policy guidelines for coverage to ensure correct billing and coding for proper payment and reduction of claim errors and denials.
โข Assists with receivables account review and reconciliation for claim rejections and denials.
โข Speaks to patients as needed in a timely and professional manner.
โข Identifies and reports issues or errors, such as incomplete or missing records and documentation, ambiguous or non-specific documentation, or codes that do not conform to approved coding guidelines while utilizing professional communication and documentation skills.
โข Demonstrates the ability to self-report daily tasks and assignments as well as identify any billing trends that affect daily productivity.
โข Other duties as assigned.
EDUCATION
โข High School Diploma / GED Certification
โข Certified Professional Coder
EXPERIENCE
โข Two years of experience in lieu of education considered
โข Next Gen Office (NGO) and Advanced MD experience preferred
โข Experience in Pain Management, Orthopedic surgery, Vascular and/or Anesthesia preferred
KNOWLEDGE
โข Knowledge of CPT, HCPCS, ICD.10 and the ability to follow coding guidelines.
โข Knowledge of Medical Terminology
โข Billing Experience or Medical Office Experience
โข Strong office and computer skills, experience with paperless workflows
โข Prior use of practice management and EMR programs
โข Basic understanding of Microsoft Office to include Outlook, Teams, MS Word, and Excel.
โข Understanding of insurance benefits, adjustments, reviews, authorizations.
SKILLS
โข Displays strong ability to prioritize, multi-task
โข Skilled communicator and ability to work effectively in resolving problemsโฏ
โข Solid organizational skills
โข Exceptional attention to detail.
โข Work independently while maintaining a positive attitude
ABILITIES
โข Ability to understand insurance payer guidelines.
โข Ability to prioritize and solve problems in a timely manner.
โข Ability to communicate effectively and professionally with insurance carriers and outside entities.
โข Ability to interact with management, physicians, and teammates at all levels and effectively.
โข Ability to communicate with teammates and management both in oral and written form.
โข Ability to meet deadlines in a fast-paced, quickly changing environment.
โข Ability to act as gatekeeper and escalate relevant information to management as needed.
โข Ability to treat confidential information with appropriate discretion.
ENVIRONMENTAL WORKING CONDITIONS
โข Normal office environment.
PHYSICAL/MENTAL DEMANDS
โข Good visual acuity, accurate color vision.
โข Requires sitting and standing associated with a normal office environment.