Billing Specialist

CODA, Inc.; Portland (OR); Presencial; USD 25 000 - 39 000; Tempo integral

Resumo da oferta

CODA, Inc. is seeking a Billing Specialist to manage all aspects of insurance and patient billing. You will perform pre-bill audits, submit claims, and respond to inquiries with accuracy and confidentiality.

You will verify CPT/HCPCS/ICD-10 codes, handle denials and AR appeals, maintain patient files, and provide data-driven insights on billing trends. A background in medical office billing and strong communication are required.

Qualificações

• Associate Degree in Accounting or Business OR three years of related field experience.
• Two years’ experience in a Medical Office setting.
• Experience with ICD-9, ICD-10 and CPT coding issues.
• Knowledge of MMIS and CIM.
• Ability to convey a positive attitude and maintain patient confidentiality.

Responsabilidades

• Facilitate timely and accurate pre-bill audit of billing system transactions.
• Prepare and submit error free claims to various insurance companies.
• Respond to patient and colleague questions promptly and efficiently.
• Verify that CPT, HCPCS and ICD-10 codes submitted to third-party payers are an accurate representation of the medical services rendered.
• Maintain patient and invoice files by entering and adjusting data.

Conhecimentos

ICD-9/10 CPT coding

AR appeals knowledge

MS Office proficiency

EMR system usage

Data entry accuracy

Formação académica

Associate Degree in Accounting or Business

Three years of related field experience

Ferramentas

MMIS

CIM (State Medicaid Reporting Systems)

Descrição da oferta de emprego

SUMMARY: The Billing Specialist is responsible for all aspects of insurance and patient billing.ESSENTIAL RESPONSIBILITIES AND TASKS:Facilitate timely and accurate pre-bill audit of billing system transactions.Prepare and submit error free claims to various insurance companies.Contact insurance companies to get authorization for patient services as necessary.Identify and resolve patient billing complaints.Count cash from PRC, prepare and balance DBR, enter into check log.Prepare, review and send patient statements.Prepare adjustments and rebills.Post and file EOBs as received.Respond to patient and colleague questions promptly and efficiently.Resolve billing issues by discussing contract with third-party payer; explaining insurance contract with patient; negotiating settlement.Maintain patient and invoice files by entering and adjusting data.Enter data accurately and efficiently into posting, charge input and authorizations.Provide billing information by collecting, analyzing, and summarizing third-party billings, accounts pending, and late charges data and trends.Verify that CPT, HCPCS and ICD-10 codes submitted to third-party payers are an accurate representation of the medical services rendered. Research any discrepancies noted prior to charge entry to ensure accuracy.Notifying the Billing Manager of any regulatory and compliance issues relating to inaccuracies or aberrant billing patterns discovered during the billing process.Achieve outcomes using methods that align with CODA’s mission and values:Communicate accurately and positively about recovery and the use of evidence-based treatments.Use data and science to identify barriers, overcome obstacles, and inform decisions.Be financially responsible; avoid waste, document accurately, seek new opportunities to serve.Demonstrate compassion and respect for others.SECONDARY RESPONSIBILITIES AND TASKS:Provide back up to Customer Service as needed.REQUIRED EDUCATION, EXPERIENCE AND COMPETENCIES:Associate Degree in Accounting or Business OR three (3) years of experience in a related field.Two years’ experience in a Medical Office setting.Experience with ICD-9, ICD-10 and CPT coding issues.Knowledge of MMIS and CIM (State Medicaid Reporting Systems).Knowledge of insurance companies and working AR appeals.Ability to convey a positive attitude and treat others with respect.Ability to take personal responsibility for the quality and timeliness of work, and achieve results with little oversight.Ability to diligently attend to details and pursue quality in accomplishing tasks.Ability to utilize both oral and written communications skills to effectively communicate with patients, co-workers, community resources, supervisors, and various other individuals encountered in the course of performing work while maintaining patient confidentiality and establishing professional rapport.Ability to operate a computer, utilize basic MS Office programs, and effectively navigate and maintain patient records in an electronic medical records system.REQUIRED CERTIFICATIONS AND LICENSES:None.PHYSICAL DEMANDS:Must be able to operate a personal computer, including reading from a computer monitor, keyboarding, and using a mouse.Must be able to reach, bend, and handle objects.Must be able to occasionally lift up to 25 lbs.OTHER REQUIREMENTS:Consistent attendance and punctuality are required of this position.A negative result on all pre-employment, reasonable suspicion, and post accident drug screens.An acceptable criminal record as determined by DHS, the Oregon Administrative Rules, and the Oregon Revised Statutes; and no current supervised parole or probation.