Medical Biller & Coder

J  o  b    D  e  s  c  r  i  p  t  i  o  n

Job Information

Title:

Medical Biller & Coder

Market Range:

MR13

Approved Date:

6/1/2021 11:57:01 AM

FLSA:

Non-Exempt

EEO Code:

PARAPROFESSIONALS

Career Level:

C2

Career Level Description:

Core Services Level 2

Job Code:

100532

Job Family:

Fiscal and Business Management

Sub Family:

Accounting

Primary Purpose

Responsible for validating, preparing and submitting patient billing and insurance information for first and third party billing. Review records of medical billing and claims, denials, settlements, and medical insurance. Respond to questions from patients, clerical staff, and insurance companies, as well as identify and resolve patient billing complaints.

•

Performs accurate and timely coding and billing (CPT, ICD9, ICD10, HCPCS, modifiers). Process claims for multiple payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.) and elevates issues, as appropriate, to the Coding Supervisor. 

1

35%

•

 Review outstanding accounts for Medicare, Medicaid, and insurances and rebill denied claims. Researches and complete necessary adjustments to client accounts.

2

25%

•

 Handles billing inquires by phone, mail and/or in person from patients, county staff (clinical & administrative),  insurance companies, Medicaid, Medicare, state and federal officials.  Follow federal and state and provider billing guidelines.

3

20%

•

Receive payments remitted electronically, by mail, by phone and occasionally in person and log in payments received.  Post payments and adjustments to accounts.  Prepare daily deposits. 

4

20%

Position(s) may perform other duties in addition to the above as assigned by management.

*IMPORTANT* In the event of an emergency, as determined by the County Manager or designee, participation in preparedness and response operations should be expected. Employee may be required to fill a temporary assignment in a role different from standard duties, work hours and/or work location in preparation for, during and after the emergency. Employee may also be required to participate in relevant exercises and regular preparedness training.

Career Level Dimensions

Career Level:

C2

Career Level Description:

Core Services Level 2

•

Works to deliver day-to-day objectives that moderately impact the achievement of the Work Group results.

•

Work typically involves regular review by senior employees and/or supervisors.

•

Responsible for making minor adjustments to work methods to solve problems that are routine and typically exist in current work processes and systems. May be required to highlight areas of concerns/problems and submit or recommend solutions to supervisor in own Work Group.

•

Communicates within and outside the Work Group to obtain or explain information.

•

May provide guidance and assistance to new or entry-level employees.

•

Requires basic job knowledge of systems and procedures obtained through prior work experience or education.

Qualifications

•

Associate's degree

•

Two years of job-related experience

•

Equivalent education and experience are accepted

•

3 Years

Office experience including maintaining patient accounts, patient check-in/ check-   out, third party insurance billing

And

•

3 Years

Billing experience with Local Health Department/Hospital setting

•

Health Services\Certified Coder-AHIMA or AAPC

Upon Hire

•

Excellent communication and customer service skills with the ability to cooperatively resolve end user issues quickly and accurately, while building relationships with internal personnel and external contacts

•

Knowledge of CPT codes medical terminology insurance plans ICD 10 codes

•

Knowledge of third-party physician billing along with a demonstrated understanding of automated processes and claims submission

•

Knowledge of administrative and clerical procedures such as file management, records management, and medical terminology.

•

Computer proficiency word, excel, outlook

•

Ability to understand, interpret, and apply the laws and regulations pertaining to billing and coding

•

Ability to work independently in carrying out oral and written instructions

An individual must be able to perform each essential duty satisfactorily to perform this job successfully. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Competencies

Attention to Detail

Thoroughness in accomplishing a task through concern for all the areas involved, no matter how small. Monitors and checks work or information and plans and organizes time and resources efficiently.

Interpersonal Skills

Treats others with courtesy, sensitivity, and respect.  Considers and responds appropriately to the needs and feelings of different people in different situations.  Perceives, assesses, and positively influences one's own and other individuals’ emotions.

Mathematical Reasoning

Uses mathematical techniques to calculate data or solve practical problems.

Time Management

Manages own time, priorities, and resources to achieve goals. Establishes a systematic course of action for self or others to ensure accomplishment of a specific objective. Sets priorities, goals, and timetables to achieve maximum productivity.

Communication

Creates an atmosphere in which timely and high-quality information flows smoothly up and down, inside and outside of the organization; encourages open expression of ideas and opinions.

Integrity

Act with honesty, transparency and respect in our interactions with co-workers and those we serve. Adhere, without exception, to laws, policies, procedures and professional standards.

Accountability

Establish high-quality standards for work. Add value. Measure results and hold self and others accountable for making progress toward desired outcomes. Take a logical and data-driven approach to decision-making.

Diversity

Believe that different backgrounds and experiences strengthen the organization and produce better results. Value inclusion across race, gender, age, religion, identity and experience, and strive to reflect in our workforce the diversity of our community.

Collaboration

Foster a work culture in which different ideas and opinions are encouraged and expected. Listen carefully and speak thoughtfully. Work together toward shared goals with mutual respect and cooperation.

Continuous Improvement

Continuously improve work processes and products. Provide a safe environment to be innovative and creative and try new things. When things don't go as planned, use it as an opportunity to learn, regroup and begin again. Provide time and resources for individuals to grow and develop both personally and professionally.

Wellness

Take proactive steps to be physically fit and healthy, emotionally strong, financially secure and socially fulfilled, while inspiring and empowering others to do the same.

Service Orientation

Commit to making a difference within the community. Actively engage in and enjoy our work. Deliver services that exceed expectations, with courtesy, politeness and sensitivity to the experiences, concerns and feelings of all co-workers and customers.

ADA Checklist

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Standard ADA Selection:

Office Environment

Standing

X

Walking

X

Sitting

X

Lifting/Carrying 0-10 pounds

X

Lifting/Carrying 10-20 pounds

X

Lifting/Carrying 20-50 pounds

X

Lifting/Carrying 50-100 pounds

X

Pushing

X

Pulling

X

Climbing

X

Balancing

X

Stooping

X

Kneeling

X

Crouching

X

Crawling

X

Reaching

X

Handling

X

Grasping

X

Fingering

X

Feeling

X

Talking

X

Hearing

X

Visual Perception

X

Repetitive Motions

X

Eye/Hand/Foot Coordination

X

Memorization/Concentration

X

Learning/Knowledge Retention

X

Preparing/Analyzing Numerical Figures

X

Use of Interfaced Commmunication Devices (Phone, Computer, Radio etc.)

X

Analyzing/Examining/Testing Data

X

Emotional/Behavioral Self-Regulation

X

Interacting with Others

X

Comprehension

X

Organization

X

Decision Making

X

Comprehension

Understand and apply routine verbal and/or written instructions

Organization

Organize and prioritize individual work schedule to manage multiple tasks and/or projects

Decision Making

Make decisions that have an impact on the individual's work

Communication

Communicate and exchange routine/basic information

Extreme cold

X

Extreme heat

X

Humid

X

Wet

X

Noise

X

Hazards

X

Temperature Change

X

Atmospheric Conditions

X

Vibration

X

Computers/Monitors

X