Medical Claims Readiness Specialist
MidlLantic Urology MidlLantic Urology Plymouth Meeting, PA Plymouth Meeting, PA Estimated:
$33.
4K - $42.
3K a year Estimated:
$33.
4K - $42.
3K a year Description:
MidLantic Urology was founded on the desire to advance urology health care for our patients.
Our merger of the top urology groups in Philadelphia not only gives us the most recognizable and skilled urologists but also empowers us with the resources to continue to innovate with the most advanced treatments backed by clinical research.
We offer a competitive salary along with a medical comprehensive medical benefit package including 7 medical plans from which to choose, dental, company paid life insurance & disability, paid time off.
, 401K Plan and more! The Medical Claim Readiness Specialist is responsible for entering and importing charges and ensuring the appropriate billing codes on used for all charges.
and to ensure charges are entered accurately, efficiently, and timely into the practice management system.
This role is also responsible for resolving all assigned claim edits and submission of claims to third party payers within the clearinghouse/practice management system in a timely and efficient manner.
Position works with RCM Manager to escalate charge entry and bill submission issues to prevent incorrect billing.
Essential Duties and
Responsibilities:
.
Enters and import charges daily for all professionals ensuring accurate coding.
Determines correct CPT codes for professional surgical procedures along with Evaluation and Management (E&M) clinical encounters.
Also determines appropriate all ICD-10 diagnosis codes.
Ensures all prior day's charges and edits have been accurately resolved and claim is ready to bill insurance in a timely manner.
Identifies root cause issues causing charge edits and communicates these issues to leadership for upstream education.
Communicates with Coders, Business Office staff and Providers when necessary to resolve errors and clarify issues.
Stays accountable to quality and productivity standards, and monitor compliance with policies and procedures.
Identifies process opportunity trends and recommend ways to improve efficiencies.
Ensures adherence to third party and governmental regulations relating to coding, billing, documentation, compliance, and reimbursement.
Participates in special projects, personal development training, and cross training as instructed Informs supervisor of trends, inconsistencies, discrepancies for immediate resolution.
Works in conjunction with peers and functional areas of the Coding and Revenue Integrity department for the betterment of completing tasks and the company overall Job may require other duties as assigned.
Requirements:
High school diploma or general education degree (GED); or equivalent combination of education and experience.
Minimum 2 years hands on coding and/or billing experience within a physician's office and/or successful completion of secondary education in medical coding/billing or medical administration, or urology experience.
Certified Professional Coder (CPC) preferred.
Experience in Urology or physician practice environment preferred.
Demonstrates and uses a strong working knowledge of CPT coding and ICD10 coding as it relates to urology services.
Understands the utilization of modifiers and other billing and coding rules to include the AMA and other billing and coding organizations.
Knowledge of medical terminology and consistent application of medical documentation requirements.
Ability to follow policies and procedures for compliance, medical billing, and coding.
Ability to type and enter data with proficiency and accuracy.
Proven ability to manage multiple projects at a time while paying strict attention to detail.
Ability to successfully meet established timelines.
Ability to operate essential office equipment, including multi-line phone, computer, fax machine, scanner, and photocopy machine.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
$33.
4K - $42.
3K a year Estimated:
$33.
4K - $42.
3K a year Description:
MidLantic Urology was founded on the desire to advance urology health care for our patients.
Our merger of the top urology groups in Philadelphia not only gives us the most recognizable and skilled urologists but also empowers us with the resources to continue to innovate with the most advanced treatments backed by clinical research.
We offer a competitive salary along with a medical comprehensive medical benefit package including 7 medical plans from which to choose, dental, company paid life insurance & disability, paid time off.
, 401K Plan and more! The Medical Claim Readiness Specialist is responsible for entering and importing charges and ensuring the appropriate billing codes on used for all charges.
and to ensure charges are entered accurately, efficiently, and timely into the practice management system.
This role is also responsible for resolving all assigned claim edits and submission of claims to third party payers within the clearinghouse/practice management system in a timely and efficient manner.
Position works with RCM Manager to escalate charge entry and bill submission issues to prevent incorrect billing.
Essential Duties and
Responsibilities:
.
Enters and import charges daily for all professionals ensuring accurate coding.
Determines correct CPT codes for professional surgical procedures along with Evaluation and Management (E&M) clinical encounters.
Also determines appropriate all ICD-10 diagnosis codes.
Ensures all prior day's charges and edits have been accurately resolved and claim is ready to bill insurance in a timely manner.
Identifies root cause issues causing charge edits and communicates these issues to leadership for upstream education.
Communicates with Coders, Business Office staff and Providers when necessary to resolve errors and clarify issues.
Stays accountable to quality and productivity standards, and monitor compliance with policies and procedures.
Identifies process opportunity trends and recommend ways to improve efficiencies.
Ensures adherence to third party and governmental regulations relating to coding, billing, documentation, compliance, and reimbursement.
Participates in special projects, personal development training, and cross training as instructed Informs supervisor of trends, inconsistencies, discrepancies for immediate resolution.
Works in conjunction with peers and functional areas of the Coding and Revenue Integrity department for the betterment of completing tasks and the company overall Job may require other duties as assigned.
Requirements:
High school diploma or general education degree (GED); or equivalent combination of education and experience.
Minimum 2 years hands on coding and/or billing experience within a physician's office and/or successful completion of secondary education in medical coding/billing or medical administration, or urology experience.
Certified Professional Coder (CPC) preferred.
Experience in Urology or physician practice environment preferred.
Demonstrates and uses a strong working knowledge of CPT coding and ICD10 coding as it relates to urology services.
Understands the utilization of modifiers and other billing and coding rules to include the AMA and other billing and coding organizations.
Knowledge of medical terminology and consistent application of medical documentation requirements.
Ability to follow policies and procedures for compliance, medical billing, and coding.
Ability to type and enter data with proficiency and accuracy.
Proven ability to manage multiple projects at a time while paying strict attention to detail.
Ability to successfully meet established timelines.
Ability to operate essential office equipment, including multi-line phone, computer, fax machine, scanner, and photocopy machine.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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