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Surgery Partners, Inc

Specialty Biller and Coder - Remote

Posted 2 months ago
2-5 years experience
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AI Summary

The role involves resolving disputed medical claims by gathering and verifying information while maintaining compliance with company standards. You will also be responsible for resolving data discrepancies and staying current on Medicaid and Medicare billing procedures.

SUPERVISION RECEIVED: Billing and Coding Supervisor


EDUCATION/EXPERIENCE:
• High school diploma.
• Minimum of two years of experience with medical office billing procedures.
• Billing Certification preferred.


KNOWLEDGE:

  • Knowledge and understanding of Physician E&M billing and coding required.
  • Certified Coder preferred.
  • Knowledge of clinic policies and procedures.
  • Knowledge of 3rd party payers, Medicare, Medicaid Billing/Collections, HCPC, CPT,  and ICD-9 coding.
  • Knowledge of computer systems, programs, data entry, and spreadsheet applications.
  • Knowledge of medical terminology and analyzing information.
  • Knowledge of collection practices.
  • Knowledge of governmental, legal, and regulatory provisions related to collection activity.

 


ESSENTIAL FUNCTIONS:
• Resolves disputed claims by gathering, verifying, providing additional information,
and following-up on claims.
• Resolves discrepancies by examining and evaluating data and selecting corrective
steps.
• Maintains work operations by following policies and procedures and reporting
compliance issues.
• Maintains quality results by following standards set forth by the company.
• Updates job knowledge by participating in educational opportunities, reading
professional publications, keeping current on Medicaid/Medicare billing, and
reimbursement procedures.
• Other assigned duties as assigned.


SKILLS:
• Skills in gathering and reporting claim information.
• Skills in solving utilization problems.
• Skills in written and verbal communication, as well as customer relations.
• Skills in working with Windows based software systems


PERFORMANCE EXPECTATIONS:
• Ability to work effectively with medical staff and external agencies.
• Ability to identify, analyze, and solve claim issues.
• Ability to deal courteously and professionally with internal and external customers.


Benefits:
• Comprehensive health, dental, and vision insurance
• Health Savings Account with an employer contribution
• Life Insurance
• PTO
• 401(k) retirement plan with a company match
• And more!

 

ENVIRONMENTAL/WORKING CONDITIONS: Normal busy office environment with much telephone work. Possible long hours as needed. The description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

*If you are viewing this role on a job board such as Indeed.com or LinkedIn, please know that pay bands are auto assigned and may not reflect the true pay band within the organization.

*No Recruiters Please

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