What are the responsibilities and job description for the Biller, Certified Coder position at Tufts Medicine?
This is a great opportunity for an experienced Biller/Coder to work close to home for a community hospital. Circle Health Lowell General Hospital offers a strong culture and work environment as well as opportunities to grow your career.
As a Biller/Certified Coder you will report directly to the Professional Billing and Coding Manager and will be responsible for the reconciliation and accurate charge entry relative to the professional services provided within practices identified in the Circle Health Physicians Entities.
The Biller/Certified Coder will assist with patient and staff questions regarding billing and coding issues, outstanding balances and payments, weekly and monthly reporting, and daily claim resolution within the practice management system.
In this role you must stay updated on CMS regulations and billing/payment guidelines for all in-network payers and maintain professional coding certification.
The main responsibilities include:
- Accurately identify individual patients in the billing system, ensures complete and accurate demographic and billing information and inputs/processes daily patient charges in a timely manner and in accordance with payer specific guidelines.
- Communicate anything identified as a billing/coding/scheduling error directly to Professional Billing and Coding Manager.
- Assist positively with all billing related patient and staff questions and phone inquiries. Participate in group call for all practices covered by the billing department (including payment collection and posting, when needed) and documents in detail within the billing system on either a claim or patient account basis.
- Stay up to date with industry details including but not limited to: reviewing all CMS and Commercial billing regulations and payer news/bulletins, CPT code additions/deletions, and billing and payment guidelines for in network plans.
- Identify, correct, and effectively process professional claims within the billing system in “Hold” and “Mgr Hold” including but not limited to: coding issues/errors, denials, appeals, global inclusion, and modifier issues/errors.
- Accurately identify proper CPT and ICD-10 codes from written and/or verbal provider description, when needed.
- Maintain professional coding certification from AAPC, AHIMA or other accredited institution by completing all necessary CEU credits in a timely fashion. Copy of re-certification given to management.
- Assist Professional Billing and Coding Manager and/or Manager of Business Operations with projects, implementations, billing reviews and/or audits as needed.
Requirements:
- 1 years of professional billing and coding experience.
- CPT Certification preferred
- Knowledge of CMS regulations a plus
- High School diploma or equivalent
What We Offer:
Not only is Lowell General Hospital an exceptional place to work, offering a culture of recognizing and valuing employees, we provide amazing opportunities for our staff:
- We promote from within whenever possible and want to see staff grow and advance in their careers
- We have competitive salaries & benefits that start on day one, generous tuition reimbursement and 403 (b) retirement plan with company match
- Free on-campus parking
About Lowell General Hospital:
Part of the Circle Health network, Lowell General Hospital is an independent, not-for-profit community hospital serving the Greater Lowell area and surrounding communities. With two primary campuses located in Lowell, Massachusetts, we are the second largest community hospital in Massachusetts. We have the latest state-of-the-art technology and a full range of medical and surgical services for patients, from newborns to seniors.
We are also a proud member of Circle Health and in collaboration with the medical community it is our promise to provide our patients with Complete connected care SM
Circle Health is an Equal Opportunity Employer.