Medical Billing Coordinator

Position Summary:

The Medical Billing Coordinator will support GrayHawk Medical Group in properly coding and submitting all Medical Billing claims produced by its Medical Group. This role is responsible for managing the claims and billing processes, assuring accurate and timely charge entry, timely clean claim creation and submission, appropriate claim status follow-up, and working claim rejections, denials, and appeals.

Essential Duties/Responsibilities:

• Identifies the correct coding applications utilizing standardized coding conventions required for the patient charge encounters when reviewing physician generated codes, ensuring compliance with regulatory agencies, correct coding initiatives, and regulatory guidelines for clinical documentation
• Identifies and reports correct code selection from physician documentation, including, but not limited to; chart notes, abstracting from medical records documentation, medical diagnostic and/or interventional reports, ensuring compliant coding selections are reported
• Charge entry and reconcile charges against patient schedules
• Ensure that patients are charged for all procedures/services
• Identify trends and provide feedback to medical staff, supervisors, and administrative staff
• Partner with providers to inform them of new coding conventions, changes in current coding conventions, and provide feedback on individual coding practices
• May include entry and confirmation of patient demographic information
• May provide education and training
• May assist with account follow-up and resolution of claim denials

Additional Duties:

• Understanding of insurance billing guidelines, including CPT codes, EOBs, and denial reasons
• Ability to problem solve by running reports in EHR and analyzing AR and payment trends
• Respond to inquiries from insurance companies, patients, and providers
• Resolving errors and making claim edits assigned in work queues
• Knowledge of Medicare fee schedules and payment terms
• Responsible for maintaining an Accounts Receivable report that summarizes the AR aging buckets and tracks denials that need to be disputed
• Responsible for reviewing claims that need to be re-submitted due to billing errors or need to be written-off
• Ability to reconcile medical EOB’s and payment reports in EHR

Education and Experience Requirements:

• 2-3+ years of professional experience in Medical Billing/coding
• Experience with HCC risk adjustment models
• Experience working within a large outpatient physician practice or ACO preferred
• Extensive Knowledge of ICD-10, CPT, and/or HCPCS

Certifications/Licensure:

Required Skills/Competencies

• Ability to learn/stay abreast of relevant Medicare billing policies/guidelines
• Critical thinking is needed when issues or concerns arise with Insurance payors
• Skilled in Microsoft Word, Excel, Outlook
• Detail oriented, organized, and a high degree of accuracy

Salary Range:

$55,000 - $70,000