Job Abstract

The Billing and Coding Specialist will ensure health providers are paid for medical services rendered. Responsible for the accurate flow of medical information and patient data between physicians, patients, and third-party payers and billing companies. Sorts and files paperwork, handles insurance claim queries, and performs collections duties as needed.

· Translate patient information and medical procedures into alphanumeric medical code that can be translated by payers, other

medical coders, and other medical facilities

· Collect, post, and manage patient account payments

· Validate patient statements

· Perform follow-up on all rejected and denied claims, ensuring timely correction and resubmission alongside outsourced team

· Monitor accounts receivables activity

· Respond to and resolve patient and insurance provider inquiries and complaints related to billing, claims, and collections

· Communicate effectively with the revenue cycle team and other departments to address and escalate issues

· Funds confirmation

· Maintain strict confidentiality

· Code patient services and enter into computer

· Sort and file paperwork

· Coordinate billing and collection activities

· Serve as the subject matter expert on coding, billing, and collections processes

· Subject matter expert on Holds and stops

The ideal candidate will have five or more years of experience ins Sleep (and/or Neuro) Diagnostic/ DME billing with EDI management.

· High school Diploma or GED required

· Associates degree preferred

· Knowledge of the basics of medicine, such as: anatomy, physiology, disease, and diagnoses is required

· Knowledge of business operations, insurance claims processes, basic office procedures and the use and application of medical

billing software required

· 5 + years of experience in billing and coding

· 3 + years’ experience with Brightree preferred

· 2+ years’ experience with DME preferred