REMOTE BILLING & CODING SPECIALIST

Definition and Role

The Remote Billing and Coding Specialist works directly with the Director of Health Informatics to ensure the coding and abstracting of documentation are conducted in an accurate, comprehensive, and efficient manner. The Remote Billing and Specialist must be experienced in all aspects of both diagnostic and procedural medical coding and billing. This role reports to the Assistant Director Revenue Cycle – Coding & Medical Records up to the Director of Revenue Cycle.

Job Responsibilities and Duties

• Verify and enter patient demographic and insurance information into practice management software.
• Abstract information from medical record and assign appropriate codes, as necessary.
• Work flexed hours to ensure claims are submitted in a timely manner.
• Strive to complete your daily claims per hour goal.
• Prepare and submit claims to third party insurance carriers either electronically or by hard copy billing.
• Post charges, payments, and adjustments.
• Understand insurance benefits including copays, deductibles, and coinsurance.
• Interacts with internal providers and external facilities to procure documentation for coding claims, as necessary.
• Research rejected and denied claims.
• Understand and apply medical terminology, ICD-10, CPT-4, & HCPCS coding guidelines & payer rules.
• Work with physicians and others to ensure complete and accurate information and optimal reimbursement based on coding.
• General sorting, filing, scanning, and faxing of documents.
• Investigate the claim, verify its
• Read, interpret, and enter information into the facility’s database using medical coding protocol to produce a statement or claim.
• Conduct various audits and data reports for supervisor.
• Performs other related duties as assigned.

Qualifications & Skills

Any combination of training, education and/or experience which provide the knowledge, skills and abilities and required conditions of employment listed below is qualifying. An example of a way these requirements might be required is

• A minimum of a bachelor’s degree in a related field is preferred, or sufficient work experience in medical billing/coding with an emphasis in clinic/hospital-based coding & billing.
• Advanced principles and practices of medical terminology, anatomy, and physiology, as well as the states, sequence, progression, and description of diseases as they apply to medical record coding and abstraction.