Wayne Professional Services LLC - Biller - Full Time

The Medical Biller/coder will review and post office, surgery, and ancillary charges and receipts for multi-specialty practice which includes primary care, general surgery, OBGYN, and cardiology.

Qualifications

• Associates Degree in related field, i.e.: Medical billing, Medical Office Administration, preferred
• 1+year previous medical billing and professional coding
• High School Diploma or GED
• High degree of knowledge with ICD-10 and CPT Coding
• Knowledge of Medicare, medicate, Medicare HMO, Medicad HMO, and commercial plans
• Must be detail oriented, highly organized, and possess strong communication skills

Skill and Responsibility

• Responsible to review and post charges and receipts.
• Claims management and evaluation of payments, denials, and appeals.
• Ensure timely and compliant billing and coding
• Prepare and submit claims via electronic billing system (EPIC)
• Ensure medical documentation required or requested by insurance companies is provided
• Review coding and compare to the progress notes for accuracy
• Follow up with insurance companies on unpaid claims until the claims are paid or only a self-pay balance remains
• Investigate claim rejections and denials.
• Process rejection of EOB’s, electronic EDI reports, electronic remits
• Work with providers and other medical personnel to ensure that correct diagnosis/procedures are reported and documented to the insurance companies.
• Post insurance adjustments.
• Maintain collection of outstanding patient accounts.
• Maintain confidentially of all information.
• Maintain and update patient account information.
• Other duties as assigned.