Certified Clinical Coder/Biller

Website Lake Superior Community Health Center

The Coder/Biller will assist with the coding, analyzing and abstracting of all medical encounters. Coding is performed in a timely manner utilizing ICD, CPT and HCPC coding guidelines and in accordance with known laws and regulations associated with medical coding. Assist with outside clinics/hospitals/patients with billing questions. Assist with monthly insurance verification. Prepare and send medical insurance claims. Assist Medical Biller with rejections and other claim issues. Backup the medical biller.

Job Qualifications:

  • Possession of a high school diploma or GED certificate• Medical terminology, coding, insurance AA degree or coding certification. Ex: AAPC’s CPC.• Minimum of verifiable two years coding experience in a primary care clinicJob Knowledge, Skills and Abilities:
  • Human anatomy and physiology and its interaction with medical terminology;• ICD, CPT and HCPC coding principals necessary to code for family practice;• Understanding of HIPAA rules and regulations and the necessity to maintain confidentiality.• Skills to use independent judgment while assisting in the coding process and awareness to interact in a proactive and positive way with providers.• Skills necessary to use the phone and provide excellent customer service while communicating with others;• Skills in using ten key and computer• Ability to handle multiple concurrent tasks and maintain orderliness and priority to those being resolved;• Ability to train others in essential duties and responsibilities.• Understanding the billing cycle from entry through payment.Licensure and Credentials:
  • Medical coding certificationFunctions and Responsibilities:
  • Review medical encounters coded by providers for accuracy and completeness prior to approving the encounter for billing.
  • Interact directly with office personnel and/or providers for clarification of documentation needed for coding and billing. Develop methodology to track coding discrepancies for feedback.
  • Interact with office personnel and/or providers to ensure all encounters and supporting documentation are collected and processed by billing department within established time frames.
  • Create and submit electronic and paper insurance claims using computerized practice management system, ensuring that claims are submitted accurately and within timely filing requirements specific to each insurer.
  • Review rejected claims and resubmit with corrections as needed.
  • Assist the medical support staff in obtaining insurance pre-authorization when required in advance of performing the procedure.
  • Assure that established policies, procedures, objectives, HIPAA, Compliance Plan and state and federal rules and laws are understood and followed.
  • Attend Compliance Committee, QI, and Staff Meetings.
  • Assist outside clinics/hospitals with billing questions, etc.
  • Acquire and maintain BH and AODA Prior Authorizations.
  • Assist with 304B Insurance and Vaccine Audits (insurance and billing part)
  • Assist with patient billing inquiries, payments and payment plans as needed.
  • Run reports as needed to complete daily, weekly and EOM billing/coding tasks.
  • Processing Sliding Fee Applications as needed.
  • Train appropriate personal on billing system.
  • Assisting Manager/Supervisor with special projects as requested.
  • Regular, punctual attendance is an essential function of the job.
  • Perform other related duties as assigned, requested, or required.

To apply for this job please visit lschc.org.