Medical Billing & Coding Specialist

　　Department: Community Health & Research Center

　　Location: Dearborn, MI

　　START YOUR APPLICATION (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?req_id=2895159&source=2895159-CJB-0)

　　Job Title: Medical Billing and Coding Specialist

　　Job Status: Part-time

　　COVID-19 VACCINATIONS: Highly recommended for all newly hired employees in Community Health and Resource Center

　　Job Summary: Under close supervision, the Medical Billing and Coding Specialist is responsible for processing health insurance claims for services provided at all clinics. Employee is responsible for submitting claims for reimbursement and coach healthcare providers to achieve optimal reimbursements.

　　Essential Duties and Responsibilities:

　　Verify the provider-s determination of services provided and patient diagnoses via office and operative notes

　　Enter charges in the billing system and/or reviews

　　Maintain complete knowledge and comply with all relevant insurance, CPT coding and diagnosis guidelines, disseminating info to staff and providers as necessary

　　Review quarterly provider audits, researching proper coding when necessary and working with coding and compliance as needed

　　Create relationships with external organizations that allow for streamlining and quick resolution of billing matters for patients

　　Document conversations with insurance companies and patients

　　Audit agency reports for procedures with office billing to ensure accuracy of billing to payers

　　Audit EMR entries to verify correct insurance and demographic information

　　Attend regularly scheduled meetings

　　Coordinate and follow through with special projects as assigned

　　Create a positive, professional, service-oriented work environment for staff, clients and family members by supporting the ACCESS mission and core values statement

　　Use a special coding system to choose diagnosis and procedure codes

　　Enter the correct codes into patients- electronic health records

　　Review claims to make sure coding is accurate

　　Work with other staff members to ensure accuracy

　　Enter insurance claims into specialized billing programs

　　Interact with patients when insurance matters need to be clarified

　　Follow up with insurers about any late payments

　　Track payments to make sure reimbursements are received on time

　　Keep in tune with changes and advancements in the field

　　May be responsible for credentialing

　　Operate standard office equipment and use required software applications

　　Perform other duties and responsibilities as assigned

　　Knowledge, Skills and Abilities:

　　Knowledge of:

　　Billing and managed care department basic services and hours of operation to respond to customer requests accurately

　　Medical, including surgical, terminology and procedures at the level needed to perform job responsibilities, including understanding of CPT and ICD-9/ICD-10 coding

　　Rules and regulations regarding insurance claim submissions

　　Skill in:

　　Operating standard office equipment and using required software applications for program area and other applications, including Microsoft Office

　　Critical thinking with the ability to effectively problem solve (e.g. able to determine if a patient issue requires immediate provider attention if there are significant changes to the patient history or other clinical issues that are presented)

　　Strong customer service skills

　　Strong multi-tasking skills

　　Organizational and time management skills to effectively juggle multiple priorities, time constraints and large volumes of work

　　Ability to:

　　Operate a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, Microsoft Word, Excel, Outlook, intranet and computer navigation

　　Use other software as required while performing the essential functions of the job

　　Communicate effectively with both written and verbal forms, including proper phone etiquette

　　Work collaboratively in a team-oriented environment; courteous and friendly demeanor

　　Work effectively with various levels of organizational members and diverse populations including ACCESS staff, patients, family members, insurance carriers, outside customers, vendors and couriers

　　Cross-train in other areas of practice in order to achieve smooth flow of all operations

　　Exercise sound judgment and problem-solving skills, specifically as it relates to resolving billing and coding problems

　　Handle patient and organizational information in a confidential manner

　　Work under minimal supervision

　　Educational/Previous Experience Requirements:

　　Minimum Degree Required:

　　Associate degree

　　Bachelor-s degree preferred

　　At least 3-5 years previous clinical billing experience or equivalent combination of education, experience and/or training approved by Human Resources.

　　Licenses/Certifications:

　　Licenses/Certifications Required at Date of Hire:

　　Medical Billing and Coding Certificate or Degree in field, Certified Professional Coder (CPC), Nationally Registered Certified Coding Specialist (NRCCS) or Registered Health Information Technician (RHIT)

　　Working Conditions:

　　Hours: Normal business hours, some additional hours may be required

　　Travel Required: Local travel may be required

　　Working Environment: Climate controlled office

　　START YOUR APPLICATION (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?req_id=2895159&source=2895159-CJB-0)