Job Description

JOB TITLE:

Specialist, Medical Billing and Coding

JOB LOCATION:

New York, NY

JOB TYPE:

Contract

JOB DESCRIPTION: 

• Partners with Operations to resolve issues surrounding unbilled claims, authorizations, Physician Certification Statements (PCSs), Patient Care Reports (PCRs), and insurance and demographic capture issues.
• Responsible for escalating concerns regarding questionable paperwork to appropriate management.
• Contact payers to verify claim status via phone or web and follow up on unpaid claims
• Process appeals on aged insurance claims/denials.
• Ability to analyze, identify and resolve issues which may cause payer payment delays
• Identify and resolve claim edits through understanding of billing guidelines and payer requirements.
• Reconcile commercial and government accounts, ensuring CPT and diagnostic codes are accurate.
• Interpret terms for Managed Care, Commercial, Medicare, Medicaid and Workers' Compensation and No Fault when applicable.
• Review all EOBs for correct payment, deductible, adjustments, and denials.
• Determining the status of claims with the insurance company, if the claim meets contractual agreements or needs adjustment.
• Reconcile account balances, and verify payments are applied correctly.
• Maintain well aged accounts, promptly resolve, and resubmit denied unpaid claims in a timely and efficient manner.
• Follow up on appeals/corrected submitted claims.
• Review and correct billing errors, which require a strong knowledge of CPT and ICD-10 coding.
• Review and audit customer service account inquiries.
• Receive inbound/outbound customer service call.
• Provide excellent customer service to all patients, Insurances & Facilities.
• Review and correct all rejections in clearing house.
• Perform all other related duties as assigned.

REQUIREMENTS:

• Must have 2-3 years of medical billing experience (required)
• Ambulance billing experience (preferred)
• Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation
• Proficient in CPT and ICD-10 coding
• Ambulance/Medical billing certification or diploma preferred
• Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) preferred
• Excellent organizational skills and the ability to multitask in a fast-paced environment
• Analytical - collects and researches data; uses intuition and experience to complement data

COMPENSATION:

$25 / hour

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