Medical Billing Coder-THIS IS NOT A REMOTE POSITION

BERTIE COUNTY RURAL HEALTH ASSOCIATION

JOB DESCRIPTION

Job Title/Description: Medical Billing Coder Department: Administration

Job Status: NON-EXEMPT Supervisor: Reports to Billing Director

Approved By: CEO Date:

Summary: This position will be responsible for all phases of the patient billing and for the filing of insurance claims including Medicaid, Medicare, Workman's Compensation, Disability and multiple third-party commercial insurance companies. This position is responsible for denial follow-ups, payment posting, patient account complaints, insurance billing and accounts receivable inquiries. This position will handle questions, complaints or problems from insurance companies.

Supervise daily billing operations to include:

• Maintains an up-to-date knowledge of any changes in insurance filing procedures and coverage limitation of the major carriers;
• Ensure that all procedural and diagnostic codes used by BCRHA are accurate and up to date.
• Monitor changing standards and methods in billing to ensure that BCRHA methods and processes are current.
• Maintain accurate and effective connections with every electronic billing “clearinghouse” used by

BCRHA.

• Study and evaluate new and changing billing requirements and recommend solutions
• Claims should be handled on an ongoing basis and all claims from one week should be filed by the end of that week;
• Confers with insurance companies and monitors delinquent claims that are more than 30 days old that have already been filed but are outstanding.
• Ensures all claims are submitted with a goal of zero errors
• Verifies completeness and accuracy of all claims prior to submission
• Monitor insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner
• Knowledge of questions to ask for proper processing of claims during denial follow-up process
• Identify coding and billing problems starting from claim creation to EOB’s and work to correct errors in a timely manner
• Review all remittance advices for accuracy to identify errors or questionable data
• Monitor patient accounts to ascertain the patient portion is being reallocated to patient
• Identify problem accounts and escalate as needed
• Update the patient account to identify actions taken on the account
• Work the patients and guarantors to secure payment on outstanding account balances
• Work with other offices to obtain necessary information to get claims processed

BERTIE COUNTY RURAL HEALTH ASSOCIATION

JOB DESCRIPTION

• Work with providers to correct diagnosis or procedure codes so that the claim can be processed

Uphold Medicare, Medicaid and HIPAA compliance guidelines in relation to billing, collections and PHI data

• Other duties may be assigned to help reach financial goals of the agency

REQUIREMENTS: The person that fills this position must have a coding certification.

QUALITIES

This job requires:

• Integrity, i.e., being honest and ethical
• Dependability, i.e., being reliable, responsible and dependable in fulfilling obligations
• Organization, i.e., approaching tasks in a logical and sequential manner, minimizing confusion and avoiding inconsistencies
• Self-Control, i.e., maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior – even in difficult situations
• Stress Tolerance, i.e., accepting criticism and dealing calmly and effectively with high stress situations
• Attention to Detail, i.e., being careful about detail and thorough in completing work tasks
• Adaptability/Flexibility, i.e., being open to change (positive or negative) and to considerable variety in the workplace
• Cooperation, i.e., being pleasant with others on the job and displaying a good-natured, cooperative attitude

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work setting:

• Medical office

License/Certification:

• Medical Coding Certification (Required)

Work Location: In person