The Billing and Coding Specialist is a temporary, full time position located centrally in Rochester, NY. The hours are Monday through Friday, 8:30 am to 5:00 pm and the pay is $15/16 per hour depending on experience.
- Evaluate medical record documentation and encounter coding to optimize reimbursement by ensuring diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit, and to ensure data comply with legal standards and guidelines.
- Interpret medical information and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct ICD 10, CPT codes and HCPCS II.
- Review Medicaid and Medicare reimbursement claims before submission for completeness and accuracy and to minimize claim denial.
- Assist staff in making changes to the electronic medical record master file as required.
- Provide technical guidance to clinical providers and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to approved coding principles/guidelines.
- Evaluate encounters for completeness and ability to be billed.
- Submit third party claims to payers for processing.
- Work denials and rejections from clearinghouse and payers.
- Contact patients to resolve billing problems.
- Follow-up on collection of aged accounts receivable.
- Post third party remittances and payments received on patient and client accounts to eMD’s, Medent and Millin/ AIRS in a timely manner.
- Reconcile industry-specific applications, i.e., eMDs, AIRS, Medent, Scriptpro, TPMS, FundEZ, to general ledger and resolve differences in a timely manner.
- Post cash receipts (electronic) to the general ledger in a timely manner.
- Prepare Bank Deposit.
- Balance deposits from the Pharmacy and Clinic to the general ledger.
- Associate's degree in a relevant field plus 5 years' experience in medical billing/coding required
- Valid Coding Certification required (CPC, CCS, CMC)
Knowledge, Skills, Abilities, and Other Characteristics
- Proficiency in Microsoft (MS) Excel and Work required
- Highly organized and strong attention to detail