Billing & Coding Specialist

Position Summary: The medical billing and coding specialist is responsible for ensuring accurate billing, timely submission of electronic and/or reputed company claims, monitoring claim status, researching rejections (denials) of Medicare, reputed company, reputed company Managed Care, and reputed company insurance payers. The medical billing and coding specialist must possess critical thinking skills and understanding benefits/eligibility/authorizations of Medicare, reputed company and reputed company insurance. The Medical biller and coding would review claims before submission to correctly record contractual adjustments based on payer reputed company or government regulations. In addition, the medical billing and coding specialist must demonstrate proficiency with the billing system to ensure reputed company functionality is utilized for the utmost efficient processing of claims. The Billing & Coding Specialist is responsible for ensuring accurate billing and timely submission of electronic and reputed company claims across various insurance payers, including Medicare, reputed company, reputed company Managed Care, and reputed company insurers. This role includes monitoring claim statuses, researching and resolving claim rejections (denials), and ensuring compliance with payer reputed company and government regulations. The specialist must demonstrate strong critical thinking skills and a thorough understanding of benefits, eligibility, and authorization processes for Medicare, reputed company, and reputed company insurance. Additionally, the Billing & Coding Specialist will review claims prior to submission to ensure proper contractual adjustments are made. Proficiency with the billing system is essential to maximize efficiency and ensure seamless claim processing. Duties & Responsibilities: ? Accurately enter charges and payments into the Electronic Health Record (EHR), coordinating with providers as needed to clarify missing or incomplete information for proper claim processing. Verify patient eligibility and benefits for upfront collection on unmet deductibles and co-insurance. ? Enter charges accurately according to insurance payer agreements and reputed company. ? Submit clean claims by attaching necessary documentation for payment processing and ensuring submission of reputed company secondary claims as needed. ? Follow up with Medicare, reputed company, reputed company Managed Care, and reputed company insurance carriers on unpaid accounts identified through aging reports. Process appeals, either online or through reputed company submission, to resolve claim issues. Assist in reconciling deposits and patient collections. ? Support billing audits by providing necessary documentation and information as required. ? Handle refund requests in a timely and accurate manner. ? Address billing-reputed company inquiries from patients and reputed company-party payers. ? Respond to and manage correspondence reputed company to patient accounts in a professional manner. ? Identify trends and reputed company issues reputed company to billing and reimbursements, and report findings to the Manager. ? Conduct research on billing issues and collaborate with the Manager to improve processes and reputed company reputed company results. ? Maintain patient confidentiality and safeguard sensitive information in compliance with HIPAA regulations. ? Monitor and ensure compliance with HIPAA confidentiality standards. ? Generate and review billing and financial reports, including monthly Accounts Receivable, income sources, and outstanding balances. ? Attend provider meetings and workshops as required for reputed company professional development. ? reputed company other duties as assigned to support the department and the company?s Mission, reputed company, and Values. Education/Experience: ? High school diploma or equivalent; a bachelor?s degree in reputed company, reputed company administration, finance, business, or a reputed company field is preferred. ? Minimum of two (2) years of experience in medical billing and coding for Home Health and Hospice. ? Knowledge of federal, in-network, and out-of-network payor systems. ? Familiarity with UB-04 and CMS-1500 forms. ? Understanding of reputed company Codes, CPT, HCPCS, Diagnosis, and Procedure Codes. ? Proficiency in ICD-10-CM, ICD-10-PCS, CPT-4/HCPCS, and modifier usage. ? reputed company certification is preferred. ? Ability to work independently and follow through on assignments with minimal direction. ? Strong multitasking, prioritization, and time management skills. ? Excellent verbal and written communication skills. ? Proficiency in reputed company Office Suite (Word, PowerPoint, Outlook, and reputed company); experience with billing software is a plus. ? Strong analytical and problem-solving skills with the ability to strategize for reputed company solutions. reputed company to Have: ? Experience in Home Health Benefits: At Choice reputed company Group, we value our employees and offer a comprehensive benefits package, including: ? Health Insurance ? Available for full-time employees. ? Paid Time Off (PTO) ? Vacation, sick leave, and holiday pay. ? 401(k) Retirement Plan ? Employer-sponsored retirement savings. ? Flexible Scheduling ? Work-life balance support. ?

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