Medical Biller

Job Description

Job Description

People's Health Centers is looking for a highly motivated Medical Biller / Coder. This is a great opportunity to work in a leading St.

Louis Federally Qualified Health Center.

Summary : Reviews charge slip coding for accuracy and completeness.

Researches appropriate procedure, diagnosis and / or modifier codes when missing or unfamiliar for approval by supervisor or physician.

Obtains proper diagnosis, procedure and modifier codes when omitted and corrects existing codes to reflect the most current and accurate codes in a timely manner.

Plans, organizes and provides training and education of physicians and staff in the proper use of service and diagnostic codes to maximize reimbursement and minimize denials / re-filing of claims.

Reviews and communicates trends in denied claims due to changes in filing requirements or coding problems.

Maintains and updates CPT and ICD-10 coding files, books and newsletters from Medicare, Medicaid, other insurance companies and Health System policies and procedures.

Audits and prepares hospital and / or clinic charges as applicable for accuracy and completeness.

Collects hospital charges from physicians at least once a week and enters charges with accuracy and in a timely manner. Enters charges in the billing system with accuracy and in a timely manner.

Researches and re-codes patient accounts for re-submission to third party insurance carriers or re-filing claims as needed.

Reviews and researches denied insurance claims; prepares for re-submission of charges.

Answers questions on appropriate use of CPT, ICD-10 modifier codes and Medicare / Medicaid regulations.

Attends classes and seminars to keep informed of current changes in coding requirements

Reads and reviews coding materials regarding coding requirements to serve as a resource for physicians and staff.

Assists clinical staff with fee estimates requested by patients.

GENERAL DUTIES :

20.1 Performs other duties as assigned by supervisor and / or manager.

20.2 Wears clothing and Health System badge consistent with dress code, and attends to personal hygiene to maintain a clean, well-groomed appearance.

20.3 Wears proper personal protective equipment when appropriate.

20.4 Observes universal precautions consistently.

Qualifications :

Education : High school graduate or equivalent. Must have attended recent courses in coding or demonstrated advanced coding and reimbursement experience.

Must have basic knowledge of medical terminology, CPT and ICD coding principles and practices. Must have computer knowledge, typing skills and knowledge of basic mathematics to make simple calculations.

Experience : Must have previous experience in insurance billing, ICD-10 and CPT coding and charge entry. Must have two years experience in a medical office setting.

Certification / Registration : CPC or RHIT required.