Employment Type : Full-Time
UROLOGY P. C. JOB DESCRIPTION: CODING AND COLLECTION SPECIALIST Reports to Billing Manager, Office Manager or Administrator. Communicates with Patients, Families, Nursing Staff, Clinical Office and Physicians. Gathers charge information, codes, enters into the system, completes billing process, and distributes billing information. Verifies and audits charges for the ambulatory surgery center. Also reviews charges and completeness of documentation prior to processing charges. Reviews past due accounts and send out accounting to doctors to get their advice as to whether to turn an account to collections or write off to bad debt. Data entry charges for the ambulatory surgical center. Research charge information and if necessary, consult with physician regarding questions. Verify that the patient is an established patient and verify DOB before posting payment or charges. Verify patient’s insurance type and if necessary, update demographic information in the system. Gathers audits, corrects ASC fee tickets with respect to proper linkage of CPT and ICD10 codes, correct level of service performed, presence of accurate demographic information, total charges and monitoring of patient’s chart to verify ticket information. Uses all resources as needed to correctly bill charges. Responsible for being up-to-date and knowledgeable of coding and diagnostic procedures, as well as being current with federal legislative changes that affect outcomes. Assists with billing questions and helps patients to understand their insurance explanation of benefits and following up with an insurance company if necessary to resolve any questions or issues. Resource person for the front office, collects past due accounts, then send letters to patients that have past due accounts asking them for payments (also done by billing). Review past due accounts and send out accounting to doctors to get their advice as to whether to turn an account to collections or to write off to bad debt. Then send letters to patients to inform them if they are cash only. Sends medical records as requested by an insurance company, for claims processing and payments. Makes transfers and corrections to patient’s accounts. Reinstates balances when appropriate. Mails insurance payment to patient if they have already paid the bill or returns to insurance company when appropriate. Maintains required records, reports, and files for all posted transactions and patient conversations in billing account activity. Must be knowledgeable of appropriate discounts for insurance companies we are contracted with and make adjustments on accounts. Must accurately post payments and apply proper adjustment or payment codes for deductibles, co-insurance, denials, etc. Attends meeting and educational activities as required. Assists with filing secondary and tertiary claims by attaching primary or secondary payer explanation of benefits. Follows up on claims that may have been denied or rejected and or give to supervisor for further review process as needed. Maintains strictest confidentiality. Adheres to the in-person attendance policies per specific department. All duties and responsibilities must be adhered to in a manner that complies with all Federal and State laws, UPC/USC standards of conduct and compliance plan and centers for Medicare and Medicaid conditions for coverage. During a Designated Health Emergency, the following become an Essential Duty: Disinfect surfaces that patients and staff members come in contact with during the course of business. This will entail using an approved disinfection agent to wipe off countertops, clipboards, exam room chairs, etc. Compliant with CMS Covid-19 vaccine mandate. Other duties may be assigned. This job has no Supervisory responsibilities Knowledge of medical terminology. Knowledge of grammar, spelling, and punctuation to type correspondence. Knowledge of industry. Skill in operating computer, printer, fax, scanner, calculator, and telephone system. Ability to read, understand, and follow oral and written instructions. Ability to speak clearly and concisely. Ability to establish and maintain effective working relationships with patients, physicians, administration, staff and the public. Must be able to assess self-learning needs and participate in educational programs as appropriate. Requires knowledge and ability in medical office procedures. Requires knowledge of agency and insurance company operating procedures and practices, particularly as they relate to levels of reimbursement. Knowledge of the computer keyboard and the operation of the computer terminal and associated printer. Ability to type at least 25 wpm and use the 10-key pad by touch. Ability to work well in Microsoft Word. Must be able to communicate effectively and work as a team within the business office. Knowledge of bookkeeping and accounting practices. Ability to understand and interpret policies and regulations. VII. EDUCATION, SKILLS AND EXPERIENCE High School Diploma or GED and coding certificate preferable. Minimum of one to two years’ experience in a medical office or hospital performing coding services and computer experience. VIII. PHYSICAL REQUIREMENTS Must be able to sit for long extended periods of time. IX. WORKING ENVIRONMENT The noise level in the work environment is usually moderate. Urology, P.C. does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor. Job Type: Full-time Pay: $19.00 - $23.00 per hour Benefits: Schedule: Application Question(s): Experience: Work Location: One location