Medical Billing and Coding Associate

Responsibilities

The Medical Billing and Coding Associate will :

• Partner with Operations to resolve issues surrounding unbilled claims, authorizations, Physician Certification Statements (PCSs), Patient Care Reports (PCRs), and insurance, and demographic capture issues
• Contact payers to verify claim status via phone or web and follow up on unpaid claims
• Process appeals on aged insurance claims / denials
• Identify and resolve claim edits through understanding of billing guidelines and payer requirements
• Reconcile commercial and government accounts, ensuring CPT and diagnostic codes are accurate
• Interpret terms for Managed Care, Commercial, Medicare, Medicaid and Workers' Compensation and No Fault when applicable
• Review all EOBs for correct payment, deductible, adjustments, and denials
• Reconcile account balances, and verify payments are applied correctly
• Maintain well aged accounts, promptly resolve, and resubmit denied unpaid claims in a timely and efficient manner
• Follow up on appeals / corrected submitted claims
• Review and correct billing errors, which require a strong knowledge of CPT and ICD-10 coding
• Review and audit customer service account inquiries
• Receive inbound / outbound customer service call
• Review and correct all rejections in clearing house
• Perform all other related duties as assigned

Qualifications :

Desired Skills :