JOB TITLE: Certified
GENERAL STATEMENT OF DUTIES:
Perform electronic and/or manual billing, and/or coding
procedures/transmittals to support physician services for a specialty
practice. Responsible for ensuring
supporting documentation relating to billing, collections and/or coding of
charges is maintained in an accurate and current manner.
Skills & Abilities: Possess a
working knowledge of billing, collections and coding concepts relative to
automated coding, billing and collection procedures while working with EMR
computer software, CPT, ICD-9 and ICD-10 in a physicians’ office. Dealing primarily with orthopaedic patients
and their coding, insurance/billing claims for services rendered by Institute
for Orthopaedic Surgery & Sports Medicine physicians. Knowledgeable about and able to explain an insurance
explanation of benefits. Understand
governmental regulations and commercial carrier guidelines regarding correct
coding and billing.
Willingness to accept day-to-day direction from Billing
Supervisor/Practice Administrator and to perform repetitive tasks. Understands and abides by the ethics of HIPAA
and confidentiality. Ability to
communicate to management, co-workers, patients and insurance carriers in a
professional manner at all times.
Ability to work well under pressure and in a team environment. Must comprehend and follow established office
routines and policies.
Education: High school diploma or GED certificate. College graduate preferred. Must have an
understanding of medical terminology and human anatomy. Must be certified as a Certified Professional
Experience: Individual shall possess a minimum of two (2)
years previous medical coding, billing and collections knowledge as well as
having worked in a physicians’ office.
Reports directly to Billing Supervisor/Practice Administrator.
TYPICAL PHYSICAL DEMANDS: Billing/Collections Associate must
be able to perform the following job functions with or without reasonable
1. Lift 15# from the floor to shoulder
2. Lift 10# overhead occasionally.
3. Carry 10#, 80 feet occasionally.
4. Push/pull 8#, 2 feet occasionally.
5. Sit up to 2 hours continuously.
6. Squat, stoop for 10 minutes occasionally.
7. Fine hand manipulation, bilaterally
8. Heavy grasp, bilaterally continuously.
9. Visual acuity corrected to 20/20.
verbal communication skills continuously.
11. Legible written
communication skills continuously.
TYPICAL WORKING CONDITIONS:
Work is performed in a medical office environment. Daily interaction with management,
co-workers, insurance carriers and patients.
DUTIES: (This list may not include all of the duties
- Responsible for the audit
and daily balancing of encounters forwarded for entry by the physicians.
- Advising and educating
physicians and support personnel of correct data in the event incomplete
data is submitted.
- Notifying the physician,
Billing Supervisor and/or Practice Administrator of any errors and/or
compliance issues noted or submitted for charge entry into the computer
- Ensuring that all missing
encounters and claims are identified and captured on a monthly basis.
- Responsible for helping in
the processing of medical appeals.
- Ability to accurately code
operative/patient notes as presented by the clinical team.
- Cross training with other
staff positions within the Corporation as designated by management.
- Review medical records,
abstract pertinent information and apply CPT, ICD-9 and ICD-10 codes as
applicable in conjunction with American Medical Association (AMA) Official
Coding Guidelines and the Standards of Ethical Coding as set forth by the
American Health Information Management Association (AHIMA).
- Remain current on medical
coding guidelines and reimbursement reporting requirements.
- Comply with HIPAA laws and
regulations recognizing a commitment to privacy, security and
confidentiality of all medical chart documentation.
- Participate in software
vendor/staff testing and training as required by the Company.
- Perform miscellaneous
duties as assigned by Billing Supervisor/Practice Administrator.