USPI Texas Orthopedic Center of Excellence is seeking a motivated Medical Biller to join our team. We have 5 OR rooms and 1 Treatment room. We perform outpatient surgical procedures in GI, Orthopedic, Pain. We are looking for a candidate to be available Monday-Friday, schedule subject to changed based on surgical schedule and flow of day. Candidate needs to be available for some early mornings and later evenings.

Job Summary: Plans, organizes and directs all aspects of the billing including the development/administration of all policies for claims processing and back up scheduling.

Duties and Responsibilities: Including but not limited to

Collaborates with Insurance Coordinator on Insurance Authorizations, claim numbers and adjusters.
Works with Pre-Admissions clerk of any cancellations and no-show fees.
Communicates with any and every Adjuster, Nurse case manager and Benefits organizer for negotiations on services rendered.
Collaborates with Business Office Manager and the Center Director.
Maintains diagnostic master file and CPT master file in accordance with SIS guidelines.
Maintains (on an interim basis) the procedure code master file; evaluates and develops new entries.
Interprets and enforces third party payer rules and regulations; including Medicare requirements.
Works with physician offices to resolve coding issues.
Maintains knowledge of and complies with established policies and procedures.
Audits accounts to assure compliance with applicable laws and regulations relative to fraud and abuse issues.
Monitors Medicare reimbursements and maintains files.
Knowledge of coding policies and procedures; established in accordance with HCFA and third-party payers.
Maintains knowledge of Medicare and third-party contracts as it relates to ASC’s.
Ensures all billing and coding requirements are completed which relate to month-end closing.
Maintains a high level of proficiency in computer applications.
Maintains the strictest confidentiality.
Scheduling back up

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Qualifications:

Five years of coding experience and/or CPC preferred.
Thorough understanding of the insurance industry and how it relates to Ambulatory Surgery Centers.
Knowledge of governmental regulations and HCFA guidelines as it pertains to coding and compliance.
Maintains a high level of proficiency in computer applications.
Skills in exercising a high degree of initiative, judgment, discretion and decision-making to achieve organizational objectives.
Skills in establishing and maintaining effective working relationships with patients, staff, physician offices, and the general public.
Ability to communicate clearly and effectively with all levels of management

USPI complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.