Accounting Career Consultants
Medical Biller / Coder St. Louis, MO
Job Reference: JOB-25994
Job Title: Medical Biller/Coder
The Coder’s primary job function is to certify accurate billing for professional services. This is accomplished through review of clinical encounters, confirming correct use of diagnosis codes (ICD-10) and procedural codes (CPT) and application of appropriate modifiers and CCI edits. The Coder provides education to providers to ensure proper completion of the medical record.
Reviews clinical encounters presented via tasking reports to ensure proper submission of services prior to billing.
· Edits and corrects diagnosis (ICD-10) and procedural codes and applies modifiers and CCI edits as required according to coding guidelines.
· Effectively utilizes coding books to confirm coding accuracy.
· Verifies referring provider, rendering provider, are accurate prior to submission of completed coding
· Reports all unresolved non-compliant coding issues immediately upon discovery
· Works with providers, clinical support staff to resolve coding (ICD-10, CPT) and documentation concerns.
· Meets on a regular basis with the Billing Manager, Providers and Clinical Staff for educating them on coding rule changes and/or coding trends and to answer coding questions.
· Participates with educational activities with clinical departments, corporate compliance, etc. to ensure lines of communication among departments remains open and positive.
· Responsible to remain current with general billing guidelines, reimbursement rules and regulations.
· Understands FQHC billing nuances to ensure accurate coding and maximum reimbursement for related services.
· Attends conferences, seminars and webinars as requested to remain current on billing related policies.
Other responsibilities may include:
· Provides information as needed for production reporting and to ensure job standards are consistently met or exceeded.
· Assists with internal audits by providing requested information and participating in review finding discussions regarding insurance processing performance. Submits to remedial training if substandard performance is identified through such audits.
· Assists co-workers and management with special projects related to claims or A/R clean- up efforts.
· To ensure uninterrupted service, participates in cross-training efforts and provides coverage for insurance processing and follow-up needs with all payers.
· Notifies management of audit requests by insurance payers and complies with requests in a timely manner.
· Certification/Licensure: AAPC Certification (American Academy of Professional Coders)-Required within 12 months of employment.
· Experience: Minimum 3 years coding experience in a healthcare setting. Strongly prefer knowledge of diagnosis (ICD-10) and procedural coding, medical terminology and insurance billing guidelines, fluent with ANSI guidelines, proficient with claims adjustment reason and remark codes FQHC certification or billing experience.
· Essential Technical/Motor Skills: Knowledge of computer applications and equipment related to work. Must have basic computer and keyboarding skills and have the ability to enter data within company’s computer system to include strong knowledge in MS Word/Excel; must demonstrate manual dexterity. Exhibit strong customer service skills, strong process improvement background.
· Interpersonal Skills: Strong interpersonal, communication skills, and the ability to work effectively with other staff and management. Demonstrated skill in developing and maintaining productive work teams. Ability to demonstrate personal integrity in all interactions.
I look forward to assisting you with your search and assessing whether this role could be a good fit for you. Please apply for confidential consideration!
Tel: 314-292-7914 | Email: email@example.com