Certified Medical Coder
Job Description
Job Description
Description : Job Summary : ?
Job Summary : ?
The Billing Specialist is responsible for processing claims for all clients, identifying and resolving claims issues adversely impacting the revenue cycle management process and achieving resolution through coordination, reconciliation, and denied claim management.
In addition, follow internal and external policies and procedures to ensure accurate revenue is booked by monitoring payments, fee schedule changes, health plan reimbursement changes and any other aspects that impact revenue, cash collections and adjustments.
Responsibilities :
Managing Invoices and Billings
- Properly codes services, procedures, diagnoses, and treatments
- AR professionals generate and distribute invoices or claims, ensuring accuracy in reflected provided products or services.
- Promptly sending claims to facilitate timely payments.
- Additionally, they diligently track outstanding payments and communicate with customers regarding their obligations.
- Follow up on denials and correcting claims
- Addressing claims placed in various hold categories by Athena staff
Monitoring and Collecting Payments :
- Tracking payments is a significant part of an AR professional role.
- They review accounts regularly, identify overdue payments and address discrepancies.
- AR professionals handle payer and customer disputes with attention to detail, accuracy and identify outstanding balances.
Maintain Customer Relationship :
- AR professional acts as a point of contact for customer payment related queries.
- Providing exceptional customer service, collaborating with all departments, and maintaining positive relationships.
- AR provides insightful reports such as payer trends, customer service complaints to upper management
Requirements :
Required Qualifications :
- High school diploma or equivalent
- Adhering to company standards of compliance with policies and procedures
- Strong written and verbal communication skills Detail-oriented with the ability to work independently and prioritize workload
- Effective organization and multitasking skills are essential
- Possess a thorough understanding of billing codes
- Knowledgeable in AHCCCS, Medicaid and CMS guidelines
- Understanding of billing regulations and compliance requirements.
- Computer skills- EMR and MS Office (Excel, Word, Outlook) to write and update notes
- Strong analytical and problem-solving skills
- Excellent Interpersonal
- Strong attention to detail
Preferred Qualifications :
- Medical Billing and Coding certificate
- Bachelor's degree
Physical Requirements : ?
- Prolonged periods sitting at a desk and working on a computer.
- Must be able to lift up to 15 pounds at a time.
- This role routinely uses standard office equipment such as computers, phones, and photocopiers.
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