Job description

JOIN OUR DYNAMIC TEAM OF PROFESSIONALS THAT DARE TO MAKE A CHANGE! OUR MISSION IS TO HEAL THE HOMELESS!

Are you a passionate self starter looking to utilize your skills and make a difference? Circle the City is the home for you! Together we can make a difference!

Hybrid Role

This position is not fully remote. Candidate must be able to come into the office when needed.

Essential Functions:

• Code claims according to coding and billing guidelines
• Bill claims in accordance with payor guidelines
• Identify and resolve complex claims and billing issues (including payer-rejected claims).
• Investigate payer- rejected claims to determine reason for denial and work to obtain resolution.
• Determine strategies to reduce denials based on denial reasons, changing laws and practices.
• Prioritize and work HOLD an MGR HOLD buckets.
• Monitor claim rejections percentages and report denial percentages regularly.
• Prepare reports out of the EHR system as needed.
• Regularly interact and assist in training of the front desk staff concerning patient insurance eligibility.
• Maintain compliance with department goals
• Analyzes and interprets patient medical records to identify and determine amount and nature of billable services; assigns and sequences appropriate diagnostic/procedure billing codes in compliance with requirements of third party payor requirements.
• Review all claims returned for Medical Necessity and correct if able; report findings to manager
• Monitors external data sources to ensure receipt and analysis of all charges.
• Ensures strict confidentiality of financial and medical records.
• Follows established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety and environmental standards.
• Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.
• Performs other duties as required.

Required Qualifications:

• Solid understanding of billing software and electronic medical records.
• Understanding of relevant laws and best practices as it relates to Medicare and Medicaid billing.
• Ability to problem solve and develop solutions.
• Understanding of HIPAA regulations and medical terminology.

Requirements (cont.)

• High school diploma required
• Experience with Excel required
• Prefer experience with Athena system
• Current certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
• 3 or more years experience as an outpatient coder
• Minimum of 5 years experience with claims billing

Physical and Mental Requirements:

• Position requires extended periods of sitting and standing including bending and reaching
• Handles stress in a positive manner
• Ability to be flexible and to multitask

Demonstrated interest in working with an under-served population

47570 47532

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Schedule:

• Monday to Friday

Experience:

• ICD-10: 1 year (Preferred)

Work Location: Remote

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