Biller/Coder | Ambulatory Revenue Cycle | Days

Overview:

The 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 patients 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 patients secondary insurance (including primary carriers 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)