Medical Billing/Coding Representative

Sports Medicine North; Peabody (MA); On-site; USD 42,000 - 62,000; Full time

Job summary

Sports Medicine North in Peabody, MA, is seeking a Medical Billing/Coding Representative to support practice revenue and patient satisfaction by filing claims, monitoring accounts, and pursuing past due balances.

The role requires a Bachelor's degree or equivalent with CPC certification and at least three years of medical office billing/coding experience. You will work with Athena/Centricity and Medi-Tech, ensuring HIPAA compliance and accurate documentation.

Qualifications

• Bachelor's Degree or equivalent experience and CPC certification.
• Three years medical office billing/coding experience.
• Knowledge of insurance regulations and HIPAA requirements.

Responsibilities

• Facilitates timely reimbursement by obtaining complete and accurate information needed for claims submission; determining primary and secondary carriers when necessary; reviewing EOBs and matching them to the appropriate claims; completing and filing paper and electronic claims on a daily basis; sending regular statements to patients with outstanding balances, etc.

Skills

Medical billing

HIPAA compliance

Customer service

Communication skills

Athena/Centricity knowledge

Education

Bachelor's degree or equivalent

CPC certification

Tools

Athena/Centricity

Medi-Tech

Job description

Job 137627 - Medical Billing/Coding Representative
Peabody, MA

PURPOSE: Supports practice revenue and patient satisfaction goals by filing insurance claims, monitoring patient accounts, taking remedial and preventive action to reduce rejected claims, securing payment on past due accounts, providing meaningful payment information to practice management.

EDUCATIONAL REQUIREMENTS: Bachelor's Degree or equivalent experience and CPC certification

EXPERIENCE: Three years medical office billing/coding experience.

ACCOUNTABILITIES:

• Facilitates timely reimbursement by obtaining complete and accurate information needed for claims submission; determining primary and secondary carriers when necessary; reviewing EOBs and matching them to the appropriate claims; completing and filing paper and electronic claims on a daily basis; sending regular statements to patients with outstanding balances, etc.
• Supports patient satisfaction goals by responding to patients' billing questions in a prompt and courteous manner; researching disputed account balances, correcting any errors (including misapplied payments and overpayments), reversing past due fees
• Supports sound practice decision making by regularly monitoring payments received, preparing patient accounts reports by payor type and status of patient accounts (number of days past due, etc.); following practice guidelines to obtain additional information from patients/payors with past due accounts, etc.
• Reduces claims rejection rate by researching rejected claims, gathering additional documentation required, correcting any errors, verifying accuracy of corrected claim, and re-filing in a timely manner; suggesting improvements in practice procedures and/or forms that would result in fewer rejected claims.
• Secures outstanding patient balances by reviewing status of delinquent accounts, establishing payment arrangements with patients, notifying patients when decision has been made to turn their account over to a collection agency, an attorney, or to small claims court; preparing paperwork for claims against past due accounts; testifying for the practice in court cases; recording any judgments with the appropriate officer(s) of the court; reporting patients to the credit bureau(s).
• Ensures compliance with all Insurances carries (Medicare/Medicaid) requirements by staying up-to-date on billing requirements.
• Protects the reputation of the practice by adhering to professional standards for collections and accounting, practice patient confidentiality policies and collections procedures, and federal (FCRA, HIPAA, etc.), state, and local statutes.
• Supports the maintenance of complete and accurate practice records by taking appropriate follow-up action on patient statements, etc. returned as undeliverable.
• Contributes to team efforts by assisting other departments at the direction of her/his manager or team lead.
• Participate in educational and professional development activities consistent with business needs.
• Maintain strictest confidentiality of medical/company information, being knowledgeable and following all HIPAA Regulations
• Perform related work as required.

Requirements

KNOWLEDGE:

• HIPAA and other regulatory policies
• Insurance regulations, policies and procedures
• Medical office procedures, policies, practices and medical terminology, telephone protocol and professional etiquette
• Electronic medical systems, including Athena/Centricity, Medi-Tech and the like.

SKILLS:

• Strong communication skills, both verbally and in writing (electronic or otherwise)
• Establishing and maintaining effective working relationships with patients, physicians, physician assistants, staff,

Insurances carriers, vendors and the public

• Extensive customer service experience
• Proven ability to multi-task
• Computer skills: proficient with Windows based software, common and extremely comfortable with navigating through various websites
• Operating all types of office equipment - hardware and software
• Strong problem solving skills and ability to think quickly, professional and efficiently
• Establishing priorities and coordinating work activities
• Preparing and maintaining records, legibly writing reports and responding to correspondence