CODER/MEDICAL BILLING SPEC

Summary of Position To assign diagnosis and procedure codes according to provider documentation adhering to the official coding guidelines set forth by the AMA, ICD-10-CM, AHIM, CMS, and HCFA. Position may also require management of accounts receivable for timely and maximum reimbursement by adhering to company billing and collection policies.

Nature and Scope The Coder/Medical Billing Specialist is responsible to assign and report these more specified codes from clear and concise provider documentation. The Coder/Medical Billing Specialist interfaces routinely with physicians, managers, and office staff to insure documentation is clear and consistent, to maintain a continuous flow of information processing. The Coder/Medical Billing Specialist is responsible to insure providers are notified of addendums to documentation as needed to insure accurate and timely processing of all third party billing (claims). The Coder/Medical Billing Specialist’s responsibilities may also include all system documentation, adjustments, charge and payment entry as required until collection or final disposition of the account balance is resolved. The Coder/Medical Billing Specialist performs daily, monthly and special system processing requirements.

Qualifications

1. Minimum High School diploma or equivalency certificate
2. Minimum of one year physician coding experience in conjunction with formal education in coding, (CPC, AHIM, RMC, CPC, CCS-P); or AB, AS from accredited college in Healthcare, which includes coding, medical terminology, and medical systems), medical terminology and/or anatomy; and/or a minimum of three years demonstrated coding “from physician documentation” experience.
3. A minimum of three years previous healthcare billing, collections experience, and/or managed care experience.
4. Knowledgeable about third party billing regulations and CPT/ICD coding.
5. Demonstrate accurate and timely data entry skills.
6. Familiar with various computer applications (ex: Microsoft Word, Excel, and billing software systems).
7. Knowledge of spreadsheet applications preferred.
8. Proven record of dependability
9. Strong people, communication and decision making skills.
10. Minimal lifting required (lift up to 27 pounds).
11. Must pass a basic CPT and ICD coding test prior to hire, if coder has no credentials.

.