Health Services Medical Biller/Coder

Linn County Department of Health Services; Albany (OR); On-site; USD 52,000 - 76,000; Full time

Job summary

Linn County Health Services in Albany, Oregon seeks a detail-oriented Medical Biller/Coder to ensure accurate coding, timely billing and proper reimbursement while maintaining compliance with HIPAA and payer requirements.

The ideal candidate has knowledge of CPT, ICD-10, HCPCS, and documentation guidelines, with experience in outpatient/physician billing, insurance follow-up, and auditing to maximize revenue.

Qualifications

• High school diploma or equivalent required.
• Two years of healthcare billing experience.
• AHIMA/AAPC billing certification required (CCS/CPC/COC/CCS-P/RHIA/RHIT).
• Medicaid/Medicare billing experience preferred.
• Pass a criminal history check and have a valid driver's license.

Responsibilities

• Code and bill outpatient/physician services with CPT/ICD-10/HCPCS guidelines.
• Audit documentation to ensure services are properly coded for reimbursement.
• Enter charges accurately into the billing system and post payments.
• Follow up on denials, rebills and aging accounts to maximize revenue.
• Maintain HIPAA/OSHA compliance and cross-cover when needed.

Skills

Attention to detail

Organizational skills

Communication skills

Healthcare coding knowledge

Teamwork

Education

High school diploma or equivalent

AHIMA or AAPC billing certification (CCS/CPC/COC/CCS-P/RHIA/RHIT)

Tools

EHR systems

Microsoft Excel

Billing software

Job description

HEALTH SERVICES MEDICAL BILLER/CODER

Administration/Billing Program (Classification 757)

SEIU Represented Full-Time (37.5 hours/week) position

Position Reopened for Applications

Linn County requires on-site work. Remote work is not available.

We are seeking a detail-oriented and dependable Medical Biller/Coder to join Linn County Health Services. In this role, you will play an essential part in ensuring accurate medical coding, timely billing, and proper reimbursement while helping maintain compliance with healthcare regulations and insurance requirements. The ideal candidate will have strong attention to detail, excellent organizational and communication skills, and a solid understanding of medical terminology, coding systems, and billing procedures. If you are passionate about supporting quality, accurate and efficient administrative processes, we would love to hear from you.

A person employed in this classification must possess the capability to perform the following duties to be considered for and remain in this position. The duties are essential functions requiring the critical skills and expertise needed to meet job objectives. Additional specific details of these essential functions may be provided by the specific office or department job announcement, if applicable.

• Strong working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines.
• Reviews and verifies documentation supporting diagnoses, procedures, treatment results, complications, potential quality of care and billing/procedural issues.
• Audit clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes and identify discrepancies and reportable elements.
• Responsible for researching codes and abstracting medical information to determine that accurate, complete and billable codes are provided for Outpatient/Physician Clinical services for the specific program. Identifies and reports coding opportunities and recommendations for improvement. Monitors report trends and escalate discrepancies to management.
• Ensure compliance with coding standards across various medical coding encounters including Mental Health, Substance Disorders and various Public Health programs.
• Input all charges related to services provided by the Health Department into the billing system in accordance with established processes with a strong emphasis on accuracy to ensure efficiency in processing and receipt of payments.
• Post all payments, by line-item, received for providers services into billing system including co-payments, insurance payments, and client payments in accordance with established processes with an emphasis on accuracy to ensure maximum revenue collection.
• Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills to achieve maximum reimbursement in a timely manner with an emphasis on client satisfaction.
• Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates.
• Follow-up on all outstanding client account balances at 60-120+ days from the date of service in accordance with practice protocol with an emphasis on maximizing client satisfaction and practice profitability using the A/R aged reports.
• Process refunds to insurance companies or client in accordance with practice protocol.
• Will be providing cross coverage with other team members.
• Maintain an organized, efficient and professional work environment.
• Adhere to all practice policies related to OSHA, HIPAA and Medicare and Medicaid Compliance.
• Assure compliance with Oregon Revised Statutes, Oregon Administrative Rules, related Federal regulations (42 CFR, etc.) and department policies.
• Able to use collaborative problem solving and communication skills in a team setting
• Develop and maintain effective, harmonious and reasonable work relationships with others.
• Maintain regular and predictable work attendance.

KNOWLEDGE, SKILL AND ABILITY:

Knowledge of outpatient code sets including CPT, HCPCS, ICD-10-CM/PCS in physician outpatient coding and reimbursement regulations; knowledge of current healthcare-based technology and Electronic Health Record (EHR) practices; coding guidelines; departmental policies and procedures; medical terminology, rules and regulations governing area of assignment; and, revenue cycle workflows. Knowledge of the principles and practices of delivery of community-based health services including: Quality assessment/improvement in a community based healthcare setting; Knowledge of state and federal privacy laws, consent for treatment and release of information, clinical treatment strategies and planning. Ability to interpret and educate staff and assure compliance with Oregon Revised Statutes, Oregon Administrative Rules, related Federal regulations (42 CFR, etc.) and department policies. Ability to develop supportive, collaborative relationships with allied service providers and agencies. Strong working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines.

EXPERIENCE, EDUCATION AND TRAINING:

Graduation from high school or equivalent is required. Two years of experience in healthcare billing or certification in healthcare billing/coding.

AHIMA or AAPC billing certification is required - Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Coding Specialist Physician based (CCS-P), Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT).

Previous coding experience within a multi-specialty clinic preferred. Some college coursework in accounting/finance with knowledge of Microsoft Excel is desired.

Must have Medicaid/Medicare billing experience.

Must be able to pass a criminal history check and possess or obtain a valid Oregon driver's license with an acceptable driving record that meets the County's requirements.

This is a non-supervisory position. Lead work/coordination of work of others is not a typical function assigned to this position. Incumbents in this position may provide training and orientation to newly assigned personnel.

VISA SPONSORSHIP

Linn County does not offer VISA sponsorship. Within three days of hire, applicants will be required to complete the US Department of Homeland Security's I-9 form confirming authorization to work in the United States. If your employment authorization and documentation is contingent on sponsorship now or in the future, you will not meet Agency employment eligibility standards.