Immediate need for a Medical Billing and Coding specialist in the Franklin, Tennessee area. This is a permanent opportunity with excellent benefits.
Job Description:
- Responsible for reviewing and correcting clinical billing with proper CPT/ICD-10/HCPCS codes
- Knowledge of commercial, government & managed care payer reimbursement
- Responsible for removing/working each edit and making changes to billing to ensure the claims are released to the intermediary
- Must ensure front office has entered the insurance accurately and confirm verification was completed.
- Responsible for verifying and pre-surgical collections on cases prior to surgery
- Must bill provider’s surgery cases timely and accurately
- Must coordinate with patient and provider staff if a patient should need to make arrangements for pre-surgical payments
- Read and understand the provider operative report to ensure accurate billing/coding and make recommendation when discrepancies are identified
- Responsible for working claims dashboard on a daily basis in order to reduce denials and unnecessary front end scrubs
- Must work through the provider commercial and patient accounts receivable each month
- Must work through provider collections work list in order to identify and place appropriate accounts with third party collections
- Responsible for filing successful appeals within timely filing limits per insurance carrier(s)
- Responsible for answering patient phone calls and face-to-face patient interaction
- Make reasonable payment arrangements with patients who have displayed a hardship based on statistical values
- Coding certification is a plus
Desired experience:
- Familiar with EOBs, Coding, and experience in EHR systems: 2 years
- High school or equivalent
Required license or certification:
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