BILLING SPECIALIST

We are seeking a detail-oriented and experienced Medical Office Coder & Billing Specialist to join our team. The ideal candidate will be responsible for accurately coding office visits and ensuring proper billing for insurance claims and patient records. This role plays a critical part in revenue cycle management and compliance with healthcare regulations. You will work closely with the billing department to obtain prior authorizations, help with Accounts Receivables, and other general billing clerk duties. You will be an integral part of the team and key to our ongoing success here at Spokane Digestive.

Duties and Responsibilities:

• Assign appropriate CPT, ICD-10, and HCPCS codes for office visits and related services.
• Review clinical documentation to ensure coding accurately reflects the services provided.
• Submit and manage insurance claims and correct denials or rejections as needed.
• Maintain up-to-date knowledge of payer rules, coding guidelines, and compliance regulations.
• Collaborate with providers and clinical staff to clarify documentation and resolve coding issues.
• Monitor and verify patient insurance coverage and benefits, when needed.
• Assist in reconciling billing discrepancies and ensuring timely and accurate reimbursements.
• Maintain confidentiality of patient records and comply with HIPAA regulations.
• Obtain written documentation, tracking, prioritizing, and reporting outcomes of each authorization request.
• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans.
• Research denials by interpreting the explanation of benefits or remittance codes and prepares appeals for underpaid, unjustly recoded, or denied claims.
• Proficient in Microsoft Office Suite, specifically Word, Excel, and Outlook.
• Collections, including documenting collection call / verification details, and working with the supervisor and sales department on accounts that need escalation.
• Ability to communicate effectively in writing, over the telephone, and in person.
• Attention to detail is critical, as is being observant and following directions.

Safety:

Spokane Digestive enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each employee is responsible for completing all training requirements, participating in emergency response tasks as requested, and serving on safety committees and teams as requested. In addition, employees must accept the responsibility for maintaining the safety of themselves and others by adhering to all written and verbal instructions, promptly reporting and/or correcting all hazards or unsafe conditions and providing feedback to supervisors and management on all safety issues.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.

This position requires the ability to occasionally lift office products and supplies, up to 20 pounds. Amount of time spent lifting or exerting force is about 50% for up to 10 pounds and less than one-third of the time up to 25 – 40 pounds.  Rarely is there a need to lift more than 41 pounds.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Working Conditions:

Work is typically performed in an interior clinical office setting. Workflow may be demanding and chaotic at times requiring the need for multitasking. Exposed to patient population that can present a variety of contagious diseases, physical injuries and emotional states of mind.

• High school diploma or equivalent required; associate degree in healthcare or business preferred.
• Minimum 1 year of medical coding experience, preferably in a physician office or outpatient setting.
• Familiarity with electronic health records (EHR) and medical billing software (e.g., Epic, eClinicalWorks, Athenahealth, etc.).
• Strong knowledge of medical terminology.
• Excellent attention to detail and analytical skills.
• Strong organizational and communication skills.
• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)
• Prior authorization: 1 year (Preferred)

Salary : $20 - $27