Address
Form of workThe Biller Coder assigns diagnoses and procedure codes to patient records for services rendered. Submits claims and
statements to third-party payers and guarantors. Maintains correspondence regarding billing questions and field calls
from patients regarding statements.
- Verifies accuracy of patient's insurance company name/address. Sends original claims along with any supporting documentation to insurance companies.
- Runs daily batch report for billing and balances to daily schedule of fees charged.
- Loads correct forms into printer and prints insurance claims; submits claims electronically when accepted by payor.
- Determines need for any supporting documentation required by the insurance company/case and copies documents for inclusion with claim form.
- Submits claim to patient's secondary insurance (including primary carrier's EOB) after receiving correct payment from primary carrier.
- Verifies accuracy of insurance payments received/posted.
- Assigns correct ICD-10-CM code to all diagnoses and correct ICD-10 PCS code to all procedures documented in the medical record.
- Assesses documentation to ensure it is adequate and appropriate to support the diagnoses and procedures to be coded.
- Receives all calls and correspondence related to patient bills, whether from patients or insurance companies. Answers billing questions in a clear and polite manner; pulls business charts/computer files as necessary to answer questions.
- Follows up with collections representative or business office manager on any problem claims regarding coding/supply charges.
Experience:
- 1-year Third Party Payer Coding experience required.
- 2 years preferred.
Skills and Abilities:
- Must be able to work on complicated accounts by diligently pursuing the reasons for lack of or incomplete payment.
- Must be able to identify the proper persons to assist with the problems.
- Must understand the priorities in which patient accounts need to be worked and proceed accordingly.
- Must understand contracts, contract language, and maintain good working relationships with payors.
Certificates/Licenses/Registration
Certified Professional Coder (CPC)orCertified Coding Specialist (CCS)orCertified Coding Associate (CCA)
