Coding and Billing Specialist Details

Coding and Billing Specialist

Mississippi Center for Advanced Medicine - United States

Employment Type : Full-Time

The Mississippi Center for Advanced Medicine is seeking to hire a Coding and Billing Specialist.

About: The Mississippi Center for Advanced Medicine (MCAM) is a healthcare facility that integrates subspecialty care, clinical pharmacy services, clinical research, and care coordination for patients in Mississippi. Our unified care process assures timely and thorough evaluations and treatments for patients who need subspecialty services. Our commitment to service assures patients, referring providers, payers, and vendors unhindered access to our providers and staff. We believe open and frequent communication combined with an integrated specialty care model will optimize quality, safety, service, outcomes, and cost for subspecialty care in Mississippi.

Coordinated Care Model: The Mississippi Center for Advanced Medicine offers a patient and family centered care team that includes sub-specialty physicians, clinical pharmacists, specialty nursing, social work/care coordination services, patient service representatives, support staff and financial services to ensure the patient and family have all the resources necessary to navigate complex medical processes and to deliver the best possible outcomes.

The Mississippi Center for Advanced Medicine is a 20-provider predominately pediatric subspecialty practice based in Madison, Mississippi with satellite offices in Tupelo and Slidell, LA. MCAM offers outreach clinics in Columbus, Hattiesburg, McComb, Meridian, Oxford, Ruleville and Southaven, Mississippi. Madison has been named the best place to live, best place to raise a family and the safest city in Mississippi. It leads the state in all socio-economic categories and well exceeds national averages for per capita income, median family income, median home value, and educational levels.

Position Summary:

The Mississippi Center for Advanced Medicine is recruiting for a Coding and Billing Specialist. Provides support to the organization ensuring accurate and timely coding and of medical records in Epic (EHR System). Prepares and forwards patient claims to appropriate third-party payers. Analyzes and reviews claims to ensure that payer-specific billing requirements are met.

The position is also responsible for working professionally with the revenue cycle team, MCAM clinical and other office staff, and patients to review, edit, submit, and follow-up on medical and pharmaceutical claims, review and follow-up denied claims, reconcile payments, and assist patients and families with any concerns regarding insurance payments or MCAM billing services.

Position Responsibilities:

• Develops an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly.
• Ability to comprehend medical record documentation to accurately assign codes in multiple specialties.
• Analyzes high-risk encounters for accurate or missing charges gaps.
• Understand complexity of billing requirements and incorporates payer specific trends into day-to-day reviews.
• Requires excellent coding knowledge of ICD 10 CM, CPT 4, and modifier application, with expectations to obtain or maintain certification (i.e. CPC or equivalent) and apply ICD 10 CM Coding Guidelines specific to all MCAM encounters.
• Develops strong working knowledge of all MCAM service lines and financial nuances of each service line including new services.
• Documents results/findings from chart reviews and provides feedback to management, providers, and office staff.
• Reviews insurance remittances to determine potential claim issues and next steps.
• Contacts insurance companies by phone to resolve problems.
• Performs appeals and claim corrections as necessary.
• Professionally responds to questions and concerns from patients.
• Communicates with billing staff team to coordinate efforts.
• Works with the MCAM Financial Manager and/or CFO to improve billing processes and reconciliation methods.
• Works with revenue cycle and other MCAM employees to answer all patient questions regarding insurance and MCAM statements in a timely, helpful and friendly manner.
• Other duties as assigned.

Position Requirements:

• Two-years or more experience with professional (physician) billing preferred
• Basic understanding of insurance terminology out-of-network benefit s vs. in-network benefits, as well as coinsurance, co-pays, and deductibles, in addition to general billing practices.
• Coding/Billing Certificate from an accredited institute or school preferred.
• Certified Professional Coder (CPC) or equivalent credential.
• Effective communication skills, both verbal and written.
• Thorough and accurate record keeping.
• Two-years or more experience with EPIC Resolute billing software preferred.
• Demonstrated ability to determine root cause of problems with medical claims.
• Accounting or related degree at an Associates level or higher preferred.
• Proficiency in Microsoft Office (Word, Excel).
• Must demonstrate excellent communication and customer service skills.
• Must demonstrate strong mathematical and reasoning skills.
• Knowledge of insurance related terminology.
• Demonstrated ability and experience to work professionally with others.
• Demonstrated ability to establish positive patient/customer rapport and build relationships.
• Strong end-user computer skills.
• All MCAM employees are required to get an annual flu vaccine.
• All MCAM employees are required to be fully vaccinated against Covid-19 prior to beginning employment according to CDC guidelines.

Compensation and Benefits

The compensation for this position will be commensurate with experience. Participation in the organization’s health insurance plan (including dental and vision insurance), and long-term disability insurance are included. MCAM provides twenty days of paid time off per year plus ten paid holidays.

Interested candidates may send their resume to Walt Rogers, CFO, at: Wcrogers@msadvancedmedicine.com