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Medical-Dental Coding Specialist

Finance
Status: 
Full Time
Department: 
Finance
Hours: 
Full Time
Description: 

MAJOR FUNCTION:
Under the supervision of Finance Revenue Cycle Manager, this position is accountable for quality, productivity, cost effectiveness and timeliness of work to ensure efficient and effective billing of all third party payers, including the proper utilization of external vendor data conversion services, where needed. Performs related work including, but not limited to:
 
ESSENTIAL FUNCTIONS:
• Work closely with Revenue Cycle Management Support Services Provider located overseas in reference to medical coding and reviewing claims processed
• Provides technical assistance and training to providers and patient representatives/call center staff, as needed. 
• Responsible to work with Quality Assurance department to establish and track quality indicators.
• Suggests and designs workflow improvements to enhance and strengthen the revenue cycle. 
• Maintains current knowledge of billing practices, procedure codes, and patient insurances.  Coordinates ICD-10 and CPT coding with the appropriate providers.
• Facilities and coordinates with Patient Representative/Call Center Supervisor feedback on errors in order to ensure registration/insurance information are properly documented.
• Provides superior customer service to all patients and takes a solutions-oriented approach to all complaints related to patient billing issues.
• Coordinates ICD-9 and CPT coding with the appropriate Provider.
• Identifies problems that impede progress to complete data input or billing process and recommends solutions.
• Conduct follow-up with insurance companies on unpaid claims, if required or necessary.
• Works closely with all front desk staff to provide feedback on errors in order to ensure insurance information is being entered properly.
• Work closely with Senior Management in order to determine and expedite claim statuses.
• Handle medical inquiries and questions related to Medical Coding via telephone or directly in a personal and professional manner.
 
ADDITIONAL RESPONSIBILITIES:
Performs any additional duties assigned by the Finance Revenue Cycle Manager.
 
EDUCATION:
• Graduation from high school or vocational school or possession of an approved high school equivalent certificate.
• One (1) - Two (2) years’ experience in work involving medical coding, submission of claims, review and working on denials with Payers. 
 
PREREQUISITES FOR THE JOB:
• Ability to work independently and to carry out assignments to completion with minimum instructions, adhere to prescribed routines and practices, maintain records, and to make reports requiring accuracy.
• Skill in the application of modern office techniques and practices and the use and care of office machines and equipment. Working knowledge of MS Word, MS Excel for Windows and willingness to learn various software packages.
• Experience with Athena (Medical Billing) and Dentrix (Dental Billing) Software a plus but not required.
 
ORGANIZATIONAL RELATIONSHIPS:
• Accountable to the CFO and Finance Revenue Cycle Manager for all phases of activities.
• Works closely with CFO and Finance Revenue Cycle Manager when system changes occur.
 
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job, the employee is regularly required to walk and talk or hear. The employee frequently is required to stand and use hands to handle, finger or feel objects, tools or controls. The employee is occasionally required to sit; reach with hands and arms; climb or balance; stoop, kneel, crouch or crawl.
• The employee must frequently lift and/or move up to ten (10) pounds and occasionally lift and/or move up to twenty-five (25) pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
 
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.