Description - In-house position responsible for the assignment of accurate E&M, ICD-9/ICD10, CPT and HCPCS codes and modifiers for various specialties. Identifies and extract information from medical records (paper or electronic) for special studies and audits. Detailed analytical reviews of physician medical records, ensuring unpaid accounts are worked correctly due to denials related to medical necessity, coding and billing guidelines. Ability to communicate with physicians and staff and to review outstanding accounts. Assist with the creation and distribution of educational materials for all providers and staff regarding medical coding and billing rules. Must have working knowledge regarding federal and local healthcare regulations, policies and procedures.
- CPC Certification preferred (preferable in various specialties)
- Candidates must possess a high school diploma or equivalent
- A minimum of three years experience in the outpatient setting (physician’s office/medical billing company) within the last five years;
- Candidates should have a minimum of 1 year of experience in accounts receivable, reviewing healthcare EOB’s, denials, payor regulations and appeals processes;
- Strong interpersonal and communication skills, including the ability to communicate effectively with a wide range of physician practices and their patients;
- Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient and ambulatory surgery) and documentation requirements;
- Familiarity with insurance reimbursement guidelines;
- Must be process and detail oriented;
- Ability to multi-task, as well as organize and prioritize work assignments;
- Ability to work independently and complete assignments timely and accurately; and
- Solid understanding and experience with Microsoft Office, including Excel.