High School Diploma or GED required; CPC certification is mandatory., 3-4 years of coding and/or medical office and billing experience is necessary., Proficiency in EMR software and multiple Microsoft Office applications is essential., Advanced knowledge in E&M and procedural coding, preferably with experience in Gastroenterology..
Key responsabilities:
Responsible for ICD and CPT coding, data entry, and claims processing for various medical services.
Perform claim scrubs for clean claim submission and manage appeals/denials effectively.
Communicate with billing companies, hospitals, and insurance payers as required for accurate claims processing.
Participate in coding audits and maintain compliance with CMS and other payer guidelines.
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As one of the largest GI practice management companies in the U.S., United Digestive focuses on building partnerships with physicians and gastroenterology practices nationwide. Our team provides strong operational infrastructure so clinicians are able to focus on delivering the highest quality patient care. We are passionate about exceeding the expectations of our providers and patients while also empowering employees, technologies, and processes to continually improve our company.
Our comprehensive service offering includes compliance, regulatory resources, revenue cycle management, human resources, technology, recruiting, marketing, and more. In addition, we offer our physician partners access to a growing suite of ancillary services, clinical research trials, as well as professional collaboration with more than 130 GI physicians and advanced practice providers.
In 2018, United Digestive was formed through a partnership between Frazier Healthcare Partners and one of the largest gastroenterology groups in the country, Atlanta Gastroenterology Associates. With more than 40 years of operational expertise and advancements in digestive healthcare services, we are proud of what we have accomplished, but we are even more excited about what we will achieve together.
Travel Percentage: As needed for business requirements.
Job Category: Revenue Cycle Management
Description
GENERAL SUMMARY OF DUTIES: Responsible for the ICD and CPT coding, data entry and claims processing of office E&M charges, office procedures, imaging, infusions, labs and other services performed by the physicians and mid-level providers of Atlanta Gastroenterology Associates.
REPORTS TO: Revenue Cycle Manager
RESPONSIBILIITES
Duties include but are not limited to:
Claim scrubs for clean claim submission.
Works appeals/denials in a timely manner and creates solutions to prevent future denials.
Communicate and work in tandem with billing company, hospitals, and insurance payers as required
Accurate coding and claims submission of services provided by Atlanta Gastroenterology Associates providers, including assigning the correct ICD and CPT codes.
Reviews and analyzes patient records to determine accurate levels of coding and other billable services.
Research coding and claims questions thoroughly in order to maintain high quality standards.
Ensures that appropriate modifiers are assigned when needed, to claim.
Provides support to office managers and staff in determining accurate coding and billing practices.
Participates in coding audits and educational endeavors as directed by the Charge Entry Supervisor
Continues personal education by attending seminars and classes as needed.
Stays up to date on changes and updates to the Current Procedural Terminology (CPT) and diagnosis codes (ICD-10).
Understands and abides by CMS and other payer guidelines in coding and billing.
Meets or exceeds quality and productivity standards as set by the Charge Entry Supervisor.
Answers emails and voicemails and returns calls in a timely and efficient manner.
Completes requests for information from other Atlanta Gastroenterology Associates staff and ensures that they are handled promptly and effectively to guarantee payment on patient accounts.
Abides by and promotes HIPAA compliance; maintains strictest confidentiality with regards to patient information.
Participates in staff meetings as directed by the Charge Entry Supervisor.
Cross trains and performs other practice functions as directed by the Charge Entry Supervisor.
Any other duties and/or special projects as assigned.
REQUIRED EDUCATION, SKILLS & EXPERIENCE
High School Diploma or GED required; CPC REQUIRED, 3-4 years of coding and/or medical office and billing experience; Skills and knowledge of EMR software functionality and operations; Proficiency in multiple Microsoft Office applications; Knowledge and ability to respond to claims questions and denials.
Advanced knowledge in E&M and procedural Coding preferred and Specialty clinical experience in Gastroenterology experience preferred.
ADDITIONAL SKILLS AND EXPERIENCE
Accounts Receivable Specialist must be able to:
Provide a high level of quality patient care and customer service at all times.
Plan, prioritize, and complete multiple tasks as delegated by RCM Leadership
Productivity based assignments to be completed within time frame assigned
Ability to work under pressure; assess, respond, and communicate issues in a timely manner.
Maintain composure and set a professional example to patients and coworkers.
Communicate clearly with patients and coworkers through the telephone, email, and in-person.
Interpret and apply clinical and non-clinical policies and procedures.
PHYSICAL/MENTAL/ENVIRONMENTAL DEMANDS
Requires sitting and standing associated with a normal office environment. Travel required as business needs dictate.
DRUG FREE WORKPLACE
United Digestive a drug free workplace. All offers of employment are contingent upon passing a pre-employment drug screening.
EQUAL OPPORTUNITY EMPLOYER
United Digestive is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, military or veteran status, gender, color or national origin in its employment practices.
Qualifications
Required profile
Experience
Spoken language(s):
English
Check out the description to know which languages are mandatory.