Seeking a full-time Medical Biller/Coder for a busy multispecialty ophthalmology office.
The Medical Biller/Coder/Collector is responsible for the timely submission of ambulatory surgical center and professional claims to insurance companies across a wide variety of medical providers and facilities. The role also includes monitoring payments, ensuring prior authorizations are obtained when needed, and serving as an intermediary between healthcare providers, clients, and health insurance companies.
This position works directly with doctors and staff to resolve billing and coding discrepancies, updates, and changes. It supports multiple providers and locations, including ambulatory surgical centers at each site, and requires strong attention to compliance, documentation, and customer service.
Essential Functions
- Current knowledge of ICD-10 and CPT coding
- Review patient bills for accuracy and completeness and obtain missing information
- Knowledge of a wide range of insurance plans and their rules and guidelines
- Identify the correct party to bill, including secondary and tertiary insurance
- Perform coding and billing tasks in a computerized health information technology system
- Use electronic health records and paper records to complete billing, coding, and collection duties while maintaining accurate, legally compliant medical records
- Process claims as they are paid and apply credits accordingly
- Provide prior authorizations and pre-determinations for planned and emergent procedures
- Review denials and partially paid claims and work with involved parties to resolve discrepancies
- Manage assigned accounts and follow up on outstanding claims with detailed documentation
- Communicate with providers, staff, patients, and insurance representatives to clarify billing issues and rule changes
- Consult with supervisors, team members, and other resources to resolve billing and collection questions
- Maintain and update fee schedules, financials, and ABNs
- Follow standards, policies, and procedures and escalate compliance issues as needed
- Perform administrative duties such as answering phones, faxing, filing confidential documents, and using the internet and email
- Work independently and collaboratively while meeting deadlines, productivity standards, and changing insurance requirements
Minimum Requirements
- High school diploma or equivalent
- Minimum of one year of current experience within the last three years in a comparable job classification preferred
- Internet, email, and data entry skills required
- Strong organizational and prioritizing skills
Benefits
- Vacation
- Sick leave
- 401(k)
- Pension
- Group health insurance
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Pay commensurate with training and experience
Location
Idaho, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago