Medical Biller

Essential Job Functions Analyzes, investigates, and resolves account issues, including resubmitting and updating line and claim document information. Accesses available resources to locate missing or incorrect information. Updates medical claims with corrected billing information and releases claims for transmission to the payer. Investigates and documents actions taken to resolve medical billing discrepancies and unusual charges and credits. Works high priority Third-Party Liability/MVA/WC cases according to department policies and procedures. Conducts research to make the determination of related paid claims for subrogation cases, which includes identification and validation of TPL/MVA/WC claims cost avoidance. Receives and responds to incoming correspondence and calls pertaining to TPL/MVA/WC verification, billing, and collections inquiries from various sources. Evaluates case status based on established criteria and takes appropriate action to maintain productive and proactive communication with the third party. Ensures that all appropriate patient service charges are entered into the billing system. Performs other duties as directed. Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance. Key Success Indicators/Attributes Ability to prioritize and multi-task in a fast-paced, changing environment. Demonstrate ability to work in all work types and specialties. Demonstrate ability to self-motivate, set goals, and meet deadlines. Demonstrate leadership, mentoring, and interpersonal skills. Demonstrate excellent presentation, verbal, and written communication skills. Ability to develop and maintain relationships with key business partners by building personal credibility and trust. Maintain courteous and professional working relationships with employees at all levels of the organization. Demonstrate excellent analytical, critical thinking and problem-solving skills. Skill in operating a personal computer and utilizing a variety of software applications. Knowledge of coding convention and rules established by the AHIMA , American Medical Association (AMA), the American Hospital Association (AHA) and the Center for Medicare and Medicaid (CMS), for assignment of diagnostic and surgical procedural codes. Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation. Supervisory Responsibility No Work Environment This job operates in a remote home office environment . This role routinely uses standard office equipment such as computers and phones . Physical Demands 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. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. Position Type/Expected Hours of Work This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work. Travel Minimal travel required; up to 5% Required Education and Experience Successful completion of an AAPC or AHIMA-approved Coding Certificate Program and a minimum of three to five years of medical billing and/or coding experience. Experience with Workers Compensation and Third-Party Liability/MVA billing and collections. Experience with Third Party Liability/Attorney collections. Preferred Education and Experience N/A Additional Eligibility Qualifications Must have the following certificates and/or licenses: CPC, COC, CIC, RHIA, RHIT, CCS, and/or CCS-P. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned. Proficient in Microsoft office software. Previous medical office experience. Familiar with billing codes i.e., HCPCS, Revenue, CPT Coding, Diagnosis Coding, etc. Experience with Epic