Billing and Coding Specialist

*Job Description* *POSITION: *Coding & Billing Specialist *DEPARTMENT: *Billing & Coding of Fargo Center for Dermatology *REPORTS TO: *Physician/Practice Director *Job Summary: *Responsible for gathering charge information and coding details and inputting data in electronic medical record and completing billing process.
The billing and coding specialist is also responsible for distributing billing information and processing/filing/appealing insurance claims.
*Education and Experience:* * Two years of experience in a medical office with coding and billing * Associate degree required * Coding certification preferred *Essential Skills and Abilities:* * Possesses wide-ranging knowledge of coding and billing.
* Excellent communication skills.
* Good problem solving and analytical skills.
* Ability to work as a team member.
* Well-organized with attention to detail.
* Ability to manage multiple projects simultaneously.
* Treats patients and co-workers with respect.
* Empathetic with patient’s financial needs and concerns.
* Regular attendance to meetings is an essential function of the position.
*RESPONSIBILITIES:* * Researches all information needed to complete billing process including getting billing information from physicians.
* Reviews coding information within electronic medical records and ensures appropriate level of coding for medical services performed.
* Assists with all cosmetic billing and works with other billing specialists to ensure completion in a timely manner.
* Assists with chart audits and collaborates with outside vendors on bi-annual chart audits * Manages pathology and laboratory charges and insurance claims from contracted service partners.
* Assists with patient prior authorization of benefits for excimer & PDT (photodynamic therapy).
* Assists in the processing of insurance claims.
* Maintains fee schedule within electronic medical record and maintain clinic fee sheets for medical & aesthetic services.
* Reviews and assists with submitting insurance claims for IG-SRT patients.
* Assists with processing all payments for IG-SRT monthly and collaborates with leadership team to process payment to external vendors.
* Enter all insurance payments and adjustments into the electronic medical record and individual patient ledgers.
* Assists with and reviews accuracy of manually entered patient payments.
* Processes all insurance provider’s correspondence, signature, and insurance forms.
* Assists patients in completing payments.
This includes payment arrangements made with patients.
Answers patient questions and concerns.
* Processes and distributes copies of billings according to clinic policies.
* Follows-up with insurance companies and ensures claims are paid/processed.
* Resubmits insurance claims that have received no response or are not on file.
* Works with other staff to follow-up on accounts until zero balance.
* Assists with pre-collections and formally works with collection company manage patients with an outstanding balance.
* Assists error resolution and oversees patient financial credits and refunds.
* Maintains required billing records, reports, files.
* Answers telephone, triages calls, takes messages, and provides information related to billing to staff and patients.
* Participates in educational activities such as webinars applicable to role.
* Maintains strictest confidentiality.
* Ensures all clinicians are credentialed and privileged with insurance companies and assists with credentialing processes.
* Other duties as assigned.
The job holder must demonstrate current competencies applicable to the job position.
*Knowledge: * * Knowledge of billing practices and clinic policies and procedures.
* Knowledge of coding and clinic operating policies.
* Knowledge of medical terminology.
* Knowledge of insurance industry.
* Knowledge of grammar, spelling, and punctuation to type correspondence.
*Skills:* * Skill in computer programs, spreadsheets, and applications.
* Skill in using a calculator.
*Abilities:* * Ability to understand and interpret policies and regulations.
* Ability to prepare documents in response to complaints and inquiries.
* Ability to examine documents for accuracy and completeness.
* Ability to read, understand, and follow oral and written instruction.
* Ability to sort and file materials correctly by alphabetical or numeric system.
* Ability to communicate effectively and work with others.
*Environmental / Working Conditions: *Work is performed remotely and involves frequent contact with staff, patients, and the public.
Work may be stressful at times.
Contact may involve dealing with difficult patient situations.
*Physical / Mental Demands: *Work may require hand dexterity for office machine operation, stooping and bending to files and supplies.
Role may also include sitting for extended periods of time.
Manual dexterity for using a calculator or computer keyboard.
*Disclaimer:* This job description is intended to provide only basic guidelines for meeting job requirements.
Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
This job description is not to be construed as a contract for employment.
Employee Signature: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Witness Signature: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Job Type: Full-time Pay: From $22.
00 per hour Benefits: * 401(k) * Dental insurance * Employee discount * Health insurance * Life insurance * Paid time off * Vision insurance Schedule: * Monday to Friday Work setting: * Clinic * Office Work Location: In person