Leavitt Family Medicine is seeking an experienced Medical Billing Specialist to join our dynamic team. The ideal candidate must be highly motivated and have an extraordinary level of attention to detail. Should also be an experienced, self-motivated problem solver with effective communication skills while also having the ability to multitask effectively in a fast-paced environment.

Working directly with our health care providers, insurance companies, and patients, you will oversee medical coding, review and submit medical claims, file and follow up on appeals, post payments, and work accounts receivable.

Responsibilities include:

Oversee all medical clinic coding and billing operations including claims, payments, accounts receivable, and collections.
Responsible for coding all medical services procedures using CPT, HCPCS, ICD-10 codes, ensuring all assigned codes are supported by proper clinical documentation.
Utilize ICD10, CPT, and HCPCS codes for reporting diagnoses and procedures.
Maintain performance and quality by conducting ongoing audits of encounters and claims to ensure codes are fully supported by clinical documentation.
Assign all potential HEDIS-allowable codes for appropriate services to be captured.
Ensure progress notes are coded accurately and to the highest level of specificity following established coding guidelines.
Abstract valid codes from hospital claims data and outpatient providers.
Work with providers for clarification and obtaining accurate and complete documentation as needed.
Enhance and maintain billing and coding knowledge and skills.
Provide feedback to management regarding any billing or coding issues.
Maintain patient confidentiality at all times per legal requirements and privacy laws.
Follow established policies and procedures.
Educate providers on billing and coding documentation requirements.
Report findings of chart audits and clinical documentation improvement (CDI) opportunities to providers to optimize coding of ongoing risk-adjusted conditions.
Review and submit claims, work rejections and denials.
Post electronic and paper payments from insurance companies and patients.
Reconcile payments daily.
Process returned payments and refund requests.
Inquire on every outstanding balance on aging report and resolve issues.
Process all accounts sent to outside collections.
Identify suboptimal patterns in provider or staff revenue cycle behaviors.
Collaborate with providers and staff on all billing and coding matters.
Conduct insurance authorizations and verification of benefits.
Perform current and retrospective health record reviews to identify gaps within clinical documentation.
Provide initial and ongoing training on documentation requirements.
Maintain strictest confidentiality; adhere to all HIPAA guidelines and regulations.
Perform duties with a high level of integrity and a strong work ethic.
Oversee complete medical clinic coding and billing pipeline.
Process all patient accounts and generate patient statements.
Diligently work accounts receivable.
Track and follow up on delinquent insurance collections and accounts receivable.
Complete and process insurance claim forms.
Process insurance collections and report results to the Practice Administrator for any required patient billing matters.
Work with insurance providers to expedite collection process.
Verify accuracy of insurance claims against encounter notes.
Process patient inquiries regarding billing and accounts.
Prepare accounts receivables and patient collections reports.
Perform data entry as needed.
Respond to correspondence from third party payers as required.
Assist front office including scheduling appointments and answering telephone calls, also assist with other clinic responsibilities as needed.

Skills and abilities:

Comfortable interacting with employees, medical staff, leadership, and medical providers
Strong analytical skills and proficiency with Microsoft Office products including Excel
Strong critical thinking skills
Ability to work independently without close supervision
Ability to meet deadlines and prioritize responsibilities
Strong ability to uphold organizational values, work with integrity, inspire trust, and treat people with respect
Strong HIPAA and OSHA knowledge

Insurance company, medical clinic and/or EMR experience preferred. Knowledge of government and commercial payor policies and medical billing experience preferred.

Benefits:

Dental insurance
Health insurance
Paid time off
Vision insurance

Work Location: In person in Hendersonville, TN