Processes and submits medical claims, assigns ICD-10 and CPT codes, reviews patient records, works denials and appeals, applies billing guidelines and modifiers, supports coding audits, and maintains HIPAA compliance. The role communicates with payers, hospitals, billing companies, patients, and practice staff while meeting coding accuracy and productivity standards.
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:
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.
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:
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.
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.
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.
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