Medical Biller/Coder at RETINA ASSOCIATES OF ORANGE COUNTY – Laguna Hills, California

We are seeking a detail-oriented and knowledgeable Medical Biller to join our medical practice. The ideal candidate will be responsible for managing billing processes, ensuring accurate coding and submission of claims, and maintaining medical records. This role is crucial in facilitating the financial operations of our medical office while ensuring compliance with healthcare regulations.

Responsibilities

• Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management
• Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection
• Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues
• Follow up on claims using various systems, such as practice management, EHR, and clearinghouse.
• Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings
• Prepares and analyzes accounts receivable reports and weekly and monthly financial reports in concert with the Practice Administrator and Operations Manager. Collects and compiles accurate statistical reports
• Audits current procedures to monitor and improve the efficiency of billing and collections operations
• Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements
• Participates in the development and implementation of operating policies and procedures
• Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures with the approval of the Director of Operations.
• Keep up to date with carrier rule changes and distribute the information within the practice
• Performs physician credentialing actions

Required Skills

• Proficiency in medical coding (ICD-10, ICD-9) and familiarity with DRG systems.
• Strong understanding of medical records management and medical terminology.
• Experience in a medical office setting with knowledge of billing software and systems.
• Excellent attention to detail with strong organizational skills.
• Ability to communicate effectively with patients, healthcare providers, and insurance representatives.
• Problem-solving skills to address billing issues efficiently and effectively.