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SalaryThis position is responsible for prompt, accurate, and effective medical insurance claim submission, with follow-up of claims to satisfactory resolution.
ESSENTIAL FUNCTIONS:
- Review medical documentation and assess for proper coding utilizing CPT, HCPCS, and ICD10 coding materials, working closely with providers and other medical staff to ensure accuracy.
- Submit clean claims to all payer types for prompt return of accounts receivable.
- Follow-up on unpaid claims and resolve any billing issues in a timely manner.
- Stay current on coding and billing guidelines for all payer types, to include commercial, government, and worker’s compensation.
- Identify accounts which may require a refund and process appropriately.
- Manage claims through various online tools and reporting systems.
- Identify education needs for providers and medical staff based on coding assessments and/or updates, and act accordingly.
- Assist patients with billing questions and issues, to include guidance on office policies regarding sliding scale discounts and payment arrangements for outstanding balances.
- Post payments in practice management system, maintain batch controls and run reports appropriately.
- Assist front office staff with billing questions relating to proper registration and scheduling of appointments as needed.
- Participate in projects, trainings, and office/staff meetings. Follow all Aviva Health policies and procedures.
QUALIFICATIONS:
- High School Diploma or GED required.
- Minimum of one years’ experience in Medical Billing utilizing ICD-10, CPT, and HCPCS coding.
- Excellent written and oral communication skills. Certification in medical coding/billing preferred.
WORKING CONDITIONS:
Must be able to perform the following physical requirements:
- Remain in a stationary position 90% of the day while performing duties.
- Move or traverse 10% of the day throughout the worksite.
- Operate equipment 100% of the day: computer, phone, printer, standard office equipment.
- Ability to communicate information and ideas clearly and accurately so others will understand; ability to interact with patients and staff clearly.
- Able to move or transport up to 5 pounds while transporting laptop computer.
- Work remotely or on-site indoors in heat-controlled environment 100% of the day.
- OSHA Exposure Category – Category #2: The normal work routine involves no exposure to blood, body fluids, or tissues.
- Remote or onsite work as directed by manager.
- Normal business hours.
- If working remotely, some travel to clinic site as directed or required.
