Billing and Coding Specialist

Starling Physicians is searching for full-time Coding Specialists located at our Corporate office in Rocky Hill, CT.

The Coding Specialist is responsible for ensuring the accurate and timely submission of claims into the practice management system. Must possess an advanced understanding of coding concepts and apply coding principles to various specialty-specific services.

Key Accountabilities

• Reviews encounter forms in Allscripts and links diagnosis codes appropriately with procedure codes according to AMA and CMS guidelines.
• Assigns ICD-10, CPT and HCPCS codes to non-Allscripts billing, including Dialysis, Infusion Center, Access Center and all other surgical procedures not billed through Allscripts, as well as the Divisions of Geriatrics and Hospitalist Medicine.
• Facilitates appointment reconciliation process by tasking for outstanding charges within 72 hours of scheduled appointment or procedure.
• Monitors incoming/submitted billing and tracks timely receipt or deficiencies therein.
• Interprets and applies LCD directives and carrier-specific policies to demonstrate medical necessity and ensure appropriate and timely payment of claims.
• Maintains positive written and verbal communications with practice contacts and physicians to assist in resolving billing inquiries.
• Contributes to departmental goals and deadlines by adhering to month-end procedures and verifying that all charges have been captured and entered appropriately within the practice management system within a two-day lag.
• Maintains quality scores of 85% or higher month over month, based on the review of work completed.
• Supports overall Central Billing Office functions by assisting with registration, charge entry, payment application, accounts receivable or other projects as requested.
• Demonstrates a commitment for learning and self-improvement. Participates in Webinars or other training and seeks opportunities to develop coding and billing acumen.
• Maintains a productive and healthy work environment, ensuring an upbeat and positive morale
• Other duties and special projects as requested.

Reports to

• Reports to the Coding Manager or Team Leader.
• Establishes and maintains effective working relationships with patients, co-workers, physicians, management, administration and external customers.

Qualifications (Education, Experience, Additional Skills & Requirements)

• High School graduate or equivalent.
• Designation of Certified Professional Coder (CPC) by the American Academy of Professional Coders is required (or must be obtained within six months).
• Minimum 1 year experience required.
• Evidence of continuing coding education required (seminar/workshop attendance, college coursework, etc.).
• Excellent computer skills including Microsoft Word, Excel and Outlook.
• Good written communication and language skills for e-mailing, tasking, and documenting specialty-specific coding guidelines and procedures.
• Ability to navigate CMS, NGS, and other websites and to research and interpret LCDs and carrier policies.
• Ability to set priorities, be organized and be a self-starter.
• Ability to work effectively and professionally under pressure.
• Ability to work in a team and to share responsibilities and duties.

Working Conditions, Physical Requirements

• Working under stress and within strict time deadlines.
• Manual dexterity required for use of calculator and computer keyboard. Use of telephone required.
• Incumbent may be required to work at any facility based on operation need, and schedule may vary.
• Travel to various practice locations will require ability to drive, valid driver’s license and use of own reliable transportation.
• Physical activity will include walking, standing, and sitting. Requires sitting for long periods of time and working in office environment. Some bending and stretching required.
• Physical demands may also include lifting and carrying equipment up to 30 lbs.
• Other physical requirements include speaking and hearing ability sufficient to communicate effectively by phone or in person at normal volumes; vision adequate to read correspondence, computer screen, forms, etc.; and good manual dexterity.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Job Type: Full-time

Benefits:

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

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Medical coding: 1 year (Preferred)

License/Certification:

• Certified Professional Coder (Preferred)

Work Location: In person