In-Office Medical Coder and Billing Specialist

Hanover Family Practice; Hanover (York County); On-site; USD 42,000 - 54,000; Full time

Job summary

Hanover Family Practice Associates, LLC is seeking a Medical Billing Specialist with at least two years of billing experience to join our in-office Billing/Collections team in Hanover, PA. The role emphasizes maximum reimbursement through follow-up on unpaid claims, data entry of patient information, and accurate posting of payments.

Key duties include submitting claims with zero errors, appealing denials when needed, and maintaining compliant handling of sensitive information.

Qualifications

• Certified Professional Coder with current credentials.
• Experience with practice management and EMR software.
• Experience with CPT, ICD-10, HCPCS coding and Level of Service audits.

Responsibilities

• Submit claims with minimal errors and follow up on unpaid claims.
• Post insurance and patient payments accurately by item line.
• Interact with payers to resolve denials and expedite reimbursements.
• Maintain patient demographic and insurance information in the system.
• Adhere to compliance policies and protect patient confidentiality.

Skills

CPC certification

EPIC experience

Excel

EMR software

CPT/ICD-10 knowledge

HCPCS

Level of service audits

Payer relations

Communication skills

Tools

Practice management software

EMR software

Microsoft Office

Job description

Growing Hanover Family Practice Associates, LLC seeks Medical Billing Specialist with a minimum of two years billing experience to become an integral part of our in-office Billing/Collections team.

This person will be a full-time, detail-oriented, goal-oriented, revenue-driven, highly accurate and motivated Biller. Primary duties include, but are not limited to: consistently follow up on unpaid claims utilizing monthly aging reports and filing appeals when appropriate to obtain maximum reimbursement. Secondary duties include but are not limited to: data entry of all patient demographic, guarantor and insurance information, posting procedures and insurance/patient payments, balance to daily deposits

REQUIRED SKILLS

• Certified Professional Coder
• Computer experience is essential, including, but not limited to: practice management software, Electronic medical record software, Microsoft Office applications.
• EPIC and Excel experience is a plus.
• Experience in CPT, ICD-10, HCPCS, and Category II Coding
• HCC - Risk Adjusting
• Perform Level of service claim audits utilizing E/M Documentation Auditor's Worksheet
• Familiarity with medical terminology.
• Excellent customer service skills.
• Strong written and verbal communication skills.
• Ability to manage relationships with various Insurance payers.
• Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
• Investigating rejected and denied claims
• Verify the accuracy of standard healthcare codes utilized prior to submission
• Responsible use of confidential information.
• Perform to company standards of compliance with policies and procedures.
• Ability to multi-task and work courteously and respectfully with fellow employees, clients and patients.

DETAILED WORK ACTIVITIES

• Ensure all claims are submitted with a goal of zero errors.
• Initiate discussions with patients regarding their patient accounts receivable
• Accurately post all insurance payments by line item.
• Timely follow up on insurance claim denials, exceptions or exclusions.
• Meet deadlines.
• Reading and interpreting insurance explanation of benefits.
• Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.
• Respond to inquiries from insurance companies, patients and providers.
• Regularly meet with Account Manager to discuss and resolve reimbursement issues or billing obstacles.
• Regularly attend monthly staff meetings and continuing educational sessions as requested.
• Perform additional duties as requested by Supervisory or Management team.