Patient Accounts Coding Specialist

New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region’s only non-profit home infusion provider. NELC is a hospital collaborative serving more than 70 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure their patients have access to a provider that reflects their commitment to excellence in patient care, quality, and service. Like our owner hospitals, NELC provides patient focused care.New England Life Care has and continues to build a diverse, inclusive, and authentic workplace, so if you’re energized by this opportunity, but your experience doesn’t support every qualification in the job posting, we encourage you to apply! You still may be the person we are looking for! New England Life Care currently has an opening for a Patient Accounts Coding Specialist / Biller. This is a full-time, hourly, non-exempt position. The normal working hours will be Monday – Friday from 8:00am until 5:00pm. Although this is a remote position, we are only hiring in the following states: Massachusetts, New Hampshire, and Maine. This person must also be certified in medical billing and coding.Job Summary: The person in this position is responsible for auditing medical records to ensure compliance with the organization's coding procedures and standards. Also reviews insurance payments and denials and recommends billing corrections.Primary Responsibilities:Audit and assign Per Diem codes to ensure PD codes are specific to therapy type.Audit Medicare and Replacement Plan claims and DIF’s to ensure that correct claims are transmitted.Maintain, create, and terminate employee web access to all payer websites. In addition, maintaining the access database in SharePoint.Support the Coding Technician as needed in reviewing clinical documentation and entering diagnosis codes, and creating DIFsSupport the Coding Technician as needed in communicating with medical providers, patients, and insurance companies to obtain proper clinical documentationSupporting the Coding Technician with assuring patient compliance with payer regulations regarding appropriate clinical documentation and insurance formsAchieve performance appraisals with "meets expectations" or betterDemonstrate independence and competence and ability to review and navigate patient accounts and delivery ticketsDemonstrate independence and competence and ability to create and accept claims from clearing houses and work claim rejections Demonstrate independence and competence in working daily billing reportsDemonstrate independence and competence and ability to teach basic billing knowledge, splitting claims, recognize billing and account errors, work To Do's and send out daily goal emails Demonstrate independence and competence and ability to bill 20 or more clean claims a day Demonstrate independence and competence and ability to bill using the payor sheetsDemonstrate independence and competence and ability to teach how to navigate through patient accounts and delivery ticketsMaintain an average of 95% or better in claim auditsAll billing queues reviewed weeklyBilling rejections worked daily from queueEducational / Professional RequirementsBachelor’s degree preferred or 2 years’ experience in coding or medical records.ICD-10 CertificationMedical knowledge of the Insurance industry3 years’ experience in healthcare setting processing healthcare provider claims or comparative experience in a healthcare setting required.A working knowledge of government health insurance plan benefits and the rules & regulations for obtaining reimbursement required.Experience with healthcare patient accounting/billing/collections computer applications including electronic claims processing preferred.Working knowledge of Home Infusion Therapy billing & collection preferred.Regulatory Requirements:Knowledge of HIPAA Privacy and Security requirementsWorking knowledge of federal / state fraud and abuse laws.Required Skills:Demonstrate a developed understanding of medical / insurance industryExcellent customer service skills required.Excellent communications (verbal and written) skills required. Excellent organizational skills required.Ability to work independently as well as part of a team required.Practical experience with microcomputer systems and applications to include Microsoft Word and Excel required.Demonstrated ability to identify, research and solve problems required."It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.”EOEMonday – Friday from 8:00am until 5:00pm

Salary : $24 - $26