Medical Coding and Billing Specialist

POSITION DESCRIPTION:

Responsible for functions of the medical billing and coding office to ensure maximization of cash flow while improving patient, physician, and other customer relations. Requires strong business office skills, including critical thinking and the ability to produce and present detailed billing activity reports.

ESSENTIAL FUNCTIONS:

• Works within the operations of the billing department, encompassing medical, dental and behavioral health coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, collections, and reimbursement management.
• Serves as the practice expert and go to person for all coding and billing processes.
• Serves as the backup and support to biller. Provide training and education for billing process to biller.
• Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.
• Analyze billing and claims for accuracy and completeness. Submit claims to proper insurance entities and follow up on any issues.
• Follow up on claims using various systems.
• Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings.
• Assists with the preparation and analysis of accounts receivable reports and insurance contracts in concert with the Practice Administrator. Collects and complies accurate statistical reports.
• Audits current procedures to monitor and improve efficiency of billing and collections operations.
• Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.
• Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to revise policies and procedures.
• Understands and remains updated with current coding and billing regulations and compliance requirements.
• Maintains working knowledge of all health information management issues such as HIPAA and all health regulation.

JOB REQUIREMENTS / EXPERIENCE:

Education: Medical billing certification required. Associates degree in business administration or related field, preferred. Certified Coder also preferred.

Knowledge, Skills, and Abilities: Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; strong knowledge of Wyoming and Federal payer regulations.

Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes.

Knowledge of business and basic accounting principles to direct the billing and coding office.

Experience: Minimum of two (2) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations is required.

A combination of education and experience will be considered. Prior experience with an electronic medical record system required.

• Covid-19 vaccination is a condition of employment. Proof of vaccination by a third party must be provided to HealthWorks by the date of hire. Per HealthWorks policy, requests for medical or religious belief exemptions may be submitted for consideration and approval.

BEHAVIORAL EXPECTATIONS:

Clinical Quality And Patient Safety

• Assumes personal responsibility for providing quality service, comfort and responsiveness as perceived by patients, visitors, physicians, and co-workers.

Service Excellence And Employee Engagement

• Demonstrates self-initiative and the ability to adapt to the challenges, conflicts, and ambiguities inherent to the position. Exhibits reliability and dependability. Reports to work on time and as scheduled. Demonstrates the willingness to accept other tasks as assigned. Exhibits ethical behavior and honesty.
• Demonstrates a commitment to individual growth and expansion of knowledge as it attributes to the position. Actively and aggressively initiates action to improve performance. Recognizes the value of teamwork and works cooperatively with others.
• Demonstrates a commitment to HealthWorks’ mission, vision, and values.

Physician & Community Relations

• Works in partnership with Cheyenne Regional Medical Center, clinic physicians and other community providers.

Financial Performance

• Demonstrates flexible and efficient time management and the ability to prioritize workload.

HOURS OF WORK / ATTENDANCE REQUIREMENTS

Hours of work may vary however the usual hours of work will be 8:00 a.m. to 5:00 p.m. Monday through Friday. Regular attendance is required.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work Location: In person