Borinquen Medical Centers is located in Miami, FL and is seeking to hire a full time Billing & Collections Coding Lead (BCCL). The BCCL will be responsible for the medical billing, coding, and collections, creating, correcting and handling claims, reviewing and completing tasks and communicating with providers and office staff on discrepancies. Oversee billing and collection department day to day operations, staffing and work as an extension of the manager. Performing all duties and responsibilities pertaining to medical billing and coding at the specialist level.
TASKS AND REQUIREMENTS
- Assist and coordinate with Manager in staff supervision and training activities.
- Run, filter and sort required reports, review and complete tasks. Document for trending purposes.
- Provide information to the practice staff and training related to denials and coding guidelines.
- Appeal Payer Claim denials
- Follow up on unpaid Accounts and advise the Manager/Director/Chief Financial Officer of new guidelines/payer requirements that could affect billing and Collections.
- To ensure that all proper information that refers to billing is tracked appropriately
- Keep the manager informed in writing of any problems and trends identified.
- Review the Accounts Receivable Aging and assign task as needed to resolve issues and ensure timely reimbursement of outstanding claims.
- Assist in managing the Billing and Reporting for BHCC Special Projects (Ryan White, SFAN, etc)
- Assist Manager or Director with Audit projects as requested.
- Support staff in assigned project-based work.
- Review the medical practice management billing system and effectively obtain necessary information for claims billing, coding and collections processes.
- Effectively work the assigned accounts, including effective oral/written communications with insurance company, clinical departments, or any staff.
- Prepare report for proper insurance contractual adjustments or policy related adjustments; and execute adjustments after management approval.
- Review the self-pay SFS accounts for proper monies allocations; transfer monies from unapplied credit to the account balance as needed.
- Work as a team member when answering patient billing questions, which includes billing hotline, patient phone calls, or written communications such as billing statements or notes from patients.
- Notify and request assistance from supervisor or manager when encountering difficult billing issues/matters related to insurance, patient billing, or clinical department requests or inquiries.
- Maintain an organized and clean environment to foster effective and productive work.
- Work as a team member when work assignments are changed or requested from management.
- Abstract pertinent information to assign all ICD-10-CM diagnosis codes, E/M codes, procedure codes, HCPCS/CPT codes, modifiers, etc. as per documentation.
- Performance of physician queries as required for clarification of documentation prior to final code assignment. Queries will be performed when information contained within the record is conflicting and/or ambiguous and requires clarification from the physician.
- Work coding related denials. May need to call insurance, work with practice, biller, as necessary.
- Provide education and feedback to staff to ensure coding and/or documentation is improved.
- Provide feedback to Billing Manager on issues discovered.
- Keep abreast of all coding guidelines, policies, laws, regulations, reimbursement and reporting requirements.
- Other duties as assigned by immediate supervisor as required.
REQUIREMENTS
- Experience and Knowledge of basic office machine, typing, computer experience preferred.
- Knowledge of Communication Programs such as MS Word, Excel, Outlook.
- Medical Billing, Coding and Collections experience; minimum one year.
- Coding Certification by the American Health Information Management Association (AHIMA) or American Association Professional Coders (AAPC) required or attained within two years of hire date and a manager/Director approved professional Coding Course within one year of hire date.
- Excellent Customer Service skills are required.
- Knowledge of general accounting helpful.
- Handle the information with high level of confidentiality.
BENEFITS
- Medical/Dental/Vision/Short Term Disability
- Company paid long term disability
- Amazing Team & Atmosphere