Must have experience in outpatient and inpatient billing; medical coders must have a good understanding of anatomy and physiology, the disease process, and clinical procedures in order to apply the correct codes that make up health records, claims, and must understand the business side of medicine.
Perform the process for health care providers to submit claims to insurance providers (payers), government programs (Medicaid/Medicare), and/or patients directly in order to receive reimbursement for services. Responsible for invoicing and collecting payments, handling denied claims and processing appeals.
• Remain knowledgeable of current medical codes required by insurers and the Department of Health and Human Services
Validate/correct codes entered by health care provider
Enter medical and billing codes into billing software(s)
•Manage databases and transfer of data from software to software
•I Work with payers and health care providers to identify billing errors and fix them
•Overcoming any challenges that apply to collecting we
•High school graduate required. College degrees and billing / healthcare courses a plus
•A strong desire to learn and to have longevity in an organization
• 4 years medical coding and billing experience plus certification in medical coding, (i.e. Certified Professional Coder) or medical billing. As an alternative,
7 years successful medical coding and billing for outpatient and inpatient health care. Without certification. Bilingual in English/ Spanish.