SHR Talent is looking for a skilled Billing Specialist to provide support for a contract assignment with one of clients. As a Billing Specialist and medical Coder, you will be responsible for analyzing physician documentation and consulting with physicians in assigning appropriate clinical diagnosis and procedure codes for a pediatric office. Successful candidates should have a familiarity with third party fee profiles and reimbursement requirements. Someone who is detail-oriented and able to meet targeted deadlines would be a good fit for this role.
Essential Job Functions
• Assigns appropriate billing codes (CPT, HCPCS, & ICD-9) based on documented services ensuring coding compliance guidelines are met.
• Assign patient accounts with the appropriate $ value as per the coding and appropriate fee schedule.
• Assist with ICD-10 implementation.
• Maintains knowledge of Managed Care and Government coverage guidelines to ensure claims meet necessary criteria for reimbursement.
• Assist with resolution of claim denials and rejections.
• Obtain prior authorizations for radiology, chemotherapy, and other ordered services.
• Ability to communicate with physicians, insurance companies, and patients to obtain required information to complete assigned tasks.
• Knowledge of CPT, ICD-9, ICD-10, CPT, and HCPCS classification systems
• An understanding of medical terminology and medical coding practices.
• Knowledge of managed care and government healthcare policies.
• Strong interpersonal /communication skills and the ability to work independently.
• Ability to prioritize and organize work area despite multi-faceted task directions and interruptions.
• Team player
• High school or equivalent
• At least 2 years of physician office billing experience with electronic practice management health record is required.