Job Description
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Medical Biller/Coder
Yonkers, NY
Billing
Non-Exempt
Jahira Gomez
Full-time
Summary Responsible for knowing, understanding, and following Insurance billing regulations for Non-Emergency and Emergency Ambulance billing. Running and providing Dept reports for monitoring purposes. Completing and maintaining projects assigned for Medicare/Medicaid
Key Responsibilities Responsible for ALL aspects of Billing and Collections for 911 and Non-Emergency Ambulance Service Provider such as Medicare, Medicaid, insurance denials.
Liaison between senior management, employees, and clients to ensure proper lines of communication critical in addressing a myriad of problems and issues requiring immediate attention and resolve.
Provide General administrative and clerical support including but not limited to, receiving, maintaining medical records, faxing, copying & scanning.
Responsible for training and coaching team members on new and/or existing procedures.
Responsible for daily/ weekly & monthly reporting of following reports & Medicare application compliance items.
Attending industry Webinars/ Conferences and preparing summary to ensure we are up to date with industry & billing compliance standards.
Responsible for reviewing PCS forms to expedite claim submission & collections.
Submitting RR Medicare record requests.
Work closely with Dept Managers/ Supervisors to create improvement & implement processes to ensure Dept goals and objectives are met in a consistent basis.
Submitting Medicare appeal via Medicare online portal to expedite payment.
Review weekly CDI lists to ensure accounts are updated timely in effort to expedite claim submission & payment.
Work on Medicare/ Medicaid denials to Identify trends & expedite claims processing & payment.
Responsible for completing Dept projects as assigned that will assist in trend analysis, compliance & revenue improvement.
Position Qualifications Education & Experience - High School Diploma, Associate degree preferred.
- Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) preferred.
- Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation.
- Ambulance/Medical billing certification or diploma preferred.
- Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR’s and all forms of medical billing (direct, 3rd party, HMO’s, private pay, no-fault, worker’s comp, Medicare & Medicaid
- Excellent organizational skills and the ability to multi-task in a fast-paced environment
- Review and research data; use intuition and experience to complement data.
- Thorough knowledge of transport documentation (PCRs)
- Ability to follow up on outstanding Medicare accounts.
- Ability able to submit appeals and overpayment requests.
- Familiar with Medicare/CMS requirements and guidelines.
- Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance.
- Excellent written and verbal communications skills required
- Excellent documentation skills (promptness, accuracy, thoroughness, and legibility).
- Medical terminology necessary.
- Customer Service/ Client relations.
Competencies - Working knowledge of EMS systems/private ambulance and medical transportation systems preferred.
- Knowledge of CONNEX preferred.
- Knowledge Microsoft Word, Microsoft Excel, and Microsoft Windows.
- Familiarity with medical terminology
- Organizational and leadership abilities, detail oriented.
Work Environment - Work is performed under normal working conditions, as in a standard office environment.
Physical Requirements - High level of sitting/working at a desk
- Light physical effort (lift/carry up to 10 lbs.)
- Must be able to perform the essential duties of the position with or without a reasonable accommodation.
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Job Tags
Full time, Work at office, Immediate start, Shift work,