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Procedural Billing Specialist I

Careers Integrated Resources Inc New York, NY (Onsite) Contractor
Duties:
Job Summary:
-Performs specialized coding services for inpatient and outpatient medical office visits. Reviews physician coding and provides updates.
-Provides comprehensive financial counseling to patients. Responsible for setting patient expectations, discussion of financial options, payment plans, one-time settlements and resolution of unpaid balances.
-Discusses with patients the details concerning their insurance coverage and financial implications of out-of-network benefits, including pre-determination of benefits, appeals and/or pre-certification limitations.
-Develop and manages fee schedules and for self-pay patients.
-Processes Worker s Compensation claims and addresses/resolves all discrepancies.
-Conducts specialized negotiations with insurance companies. Brokers and negotiates with insurance carriers. Establishes a network of key representatives within the insurance pre-certification units to establish open lines of communication for future service negotiation.
-Verifies insurance and registration data for scheduled office, outpatient, and inpatient procedures. Reviews encounter forms for accuracy. Responsible for obtaining pre-certifications for scheduled admissions.
-Enters office, inpatient, and/or outpatient charges with accurate data entry of codes.
-Posts all payments in IDX. Runs and works missing charges, edits, denials list and processes appeals. Posts denials in IDX on a timely basis.
-Provides comprehensive denial management to facilitate cash flow. Tracks, quantifies and reports on denied claims.
-Directs and assists with responses to problems or questions regarding benefit eligibility and reimbursement procedures.
-Researches unidentified or misdirected payments.
-Works credit balance report to ensure adherence to government regulations/guidelines.
-Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations.
-Identifies and resolves credentialing issues for department physicians.
-Maintains a thorough understanding of medical terminology through participation in continuing education programs to effectively apply ICD-10-CM/PCS, CPT and HCPCS coding guidelines to inpatient and outpatient diagnoses and procedures.
-Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns.
-Mentors less experienced billing staff and assists Billing Manager/Revenue Cycle Manager in staff training.
-Other identified duties as assigned.

Education:
Required Education:
-N/A
Preferred Education:
-Associate s degree preferred.
Required Certifications & Licensure:
-N/A
Preferred Certifications & Licensure:
-N/A

Languages:
English( Speak, Read, Write )

Skills:
Required Skills & Experience:
-Excellent organizational skills.
-Excellent communication and customer service skills.
-Knowledge of medical terminology and anatomy.
-Strong attention to detail and ability to multitask.
-Excellent calculation, verbal and communication skills.
-Strong ability in analysis and research.
Preferred Skills & Experience:
-N/A

City: New York

Schedule:
Start Date: 11/18/2024
End Date: 02/15/2025
Schedule Notes: 9am-5pm M-F Urology coding experience
Hours Per Week: 37.50
Hours Per Day: 7.50
Days Per Week: 5.00 Skills:

Required

  • ORGANIZATIONAL SKILLS
  • CLAIMS
  • BILLING
  • PCS
  • RETAIL SALES


Additional

  • CPT
  • CREDIT TASKS
  • PAYMENTS
  • ACCURATE DATA ENTRY
  • ICD
  • STAFF TRAINING
  • MENTORS
  • CREDIT ISSUES
  • CREDIT SCORES
  • CODING
  • OUTPATIENT
  • CUSTOMER SERVICE ORIENTED
  • IDX
  • SETTLEMENTS
  • CASH FLOW
  • OFFICE MEDICAL
Languages: English( Speak, Read, Write ) Start Date: 11/18/2024 Hours Per Week: 37.50 Est. End Date: 02/15/2025 Hours Per Day: 7.50 Schedule Notes: 9am-5pm M-F Urology coding experience Days Per Week: 5.00 Department: UROLOGY BILLING ACCOUNT B : 02651476XXXX
MSM Cloud Department: Dept / Floor: 6th floor Shift Hours: 9am-5pm M-F Contract Type: Local Union Position?: No Compliance Analyst: Initial Start Date: On-Call Required?: No Min. Pay Rate: Max. Pay Rate:
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Job Snapshot

Employee Type

Contractor

Location

New York, NY (Onsite)

Job Type

Other

Experience

Not Specified

Date Posted

10/30/2024

Job ID

24-28894

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