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.
- 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 clinic
Job 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.Functions 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.