Conway, South carolina
CPC-Patient Services Rep - biller/coder Job Opening in Conway, South carolina - Careteam+ Family Health & Specialty Care is a growing medical practice located in Conway, SC. Our expansive facility offers state of the art medical equipment, onsite laboratory, and dedicated treatment and procedure rooms. We have Primary care, Pediatrics and Specialty care. Our professional healthcare providers are dedicated to patient centered care, and using their skills to improve lives through positive healthcare management. Careteam Plus offers a competitive salary and benefits package for our employees.
POSITION SUMMARY
Under general supervision the Chief Financial Officer you will be a one person coding and billing department. This is an IN-HOUSE position. Organized, proactive and ability to work independently in all facets of the medical billing department from coding to accounts receivable. Non-profit or rural health community experience is a plus in this position.
Responsibilities:
You are responsible for accurately abstracting and assigning valid ICD and CPT codes to ensure appropriate reimbursement in accordance with federal and state regulatory guidance.
You will also determine the most appropriate diagnosis after a thorough review of the medical records and works closely with practice staff and physicians regards to coding and assignment.
Must ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission of billing for payment.
Responsible for performing claim research and follow-up work with insurance companies to resolve accounts which have been billed but remain unresolved.
Reviewing notes on client systems to see what work has already been performed.
Determining next steps by either calling the insurance company or using electronic tools to determine claim status.
If no claim is on file, it will need to be re-billed through the client's systems.
If a claim is rejected, find out why and make a determination if it can be re-billed with proper information, if it should be patient responsibility, or if it is a timely filing issue.
If coding needs to be changed, submit to appropriate group for review. * Work specific payers and accounts as assigned by management.
Responsible for submitting accounts to be written off or changed to patient responsibility.
Responsible for claim denials and determining how to resolve the claim either by correction, re-billing, or if it was rejected authorization issues.
Providing weekly reports on claims worked, re-billed, and submitted for write-off.
Responsible for working from multiple computer systems simultaneously and learning them quickly.
Responsible for posting incoming payments and contractual write-offs.
Customer Service driven individual with the ability to set up payment plans with patients when needed in a kind and professional manner.
BILLING COMPANIES AND CANDIDATES THAT CANNOT BE ON SITE NEED NOT APPLY
EDUCATION AND EXPERIENCE
Certified Professional Coder (CPC)
2 years A/R experience
3 years Coding and Billing Experience
Non-profit, Ryan White, FQHC Look- Alike or Rural Health Experience a plus
EEO Employer
Job Type: Full-time
Required experience:
Billing: 3 years
A/R: 2 years
Required license or certification:
Certified Professional Coder (CPC)
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