Position Summary: WORK ON SITE

A wonderful and exciting career opportunity for a Medical Billing and Coding Specialist is now available with a prestigious and growing FQHC Federally Qualified Health Center in historic Aiken, South Carolina!

We are seeking a qualified and dedicated medical coding & billing specialist to join our administrative office. In this position, you will be responsible for a variety of tasks requiring data analysis, in-depth evaluation, and sound judgment. Under the direction of the RMCM our medical coding & billing specialist’s daily duties will include maintaining billing software, appealing denied claims, and recording payment, claims follow up, and denial resolution.

The ideal candidate must also be able to demonstrate excellent written/verbal communication skills, analytical decision making, work independently as well as part of the team. To succeed in this role, you must possess in-depth knowledge of billing software and medical insurance policies.

Essential Functions/Responsibilities:

• Processes billings to patients and third-party reimbursement claims; maintains supporting documentation files and current patient addresses.
• Processes patient statements and insurance explanation of benefits, keys data, posts transactions and adjustments; and verifies accuracy of input to reports generated.
• Researches and responds by telephone and in writing to patient inquiries regarding billing issues and problems. Submits correction request forms to appropriate staff members.
• Follows up on submitted claims; monitors unpaid claims, initiates tracers; resubmits claims as necessary.
• Posts and reconciles payments to patient accounts and general ledgers.
• Balances and posts daily batches and reports.
• Provides patients with needed information and ensures patient confidentiality.
• Maintains patient demographic information and data collection systems.
• Performs a variety of general clerical duties, including telephone reception, courier, and other routine functions.
• May assist in preparing patient statements, documentation and responses for legal inquiries, litigation, and court appearance.
• Ensures strict confidentiality of financial records.
• Performs miscellaneous job-related duties as assigned.

Performance Improvement Activities/Safety/Infection Control Activities

• Participates in the community health center’s quality assurance activities and performs duties in accordance with applicable standards.
• Ensures an appropriate environment for the administration of health care activities and keeps workstation, all equipment, and other work areas in a clean, safe, and orderly fashion.
• The ability to carry out the assigned duties independently or with only minimal supervision.
• The ability to read medical, legal, and insurance documents.
• The ability to establish and maintain appropriate filing system for the retrieval of needed information.
• The ability to communicate and relate effectively to staff, patients, and representative of third-party payers and the ability to work as a “team” member of the medical office staff.
• The ability to prioritize multiple tasks and perform efficiently and effectively in a stressful environment.
• The ability to be bonded for the handling of cash receipts.
• A minimum of two years of experience in a primary health care, or equivalent, environment.
• Demonstrate the ability to deal with the public.
• Ability to prioritize multiple tasks and perform efficiently and effectively in a stressful environment.
• The ability to use required office machines and personal computers.
• The ability to communicate with the public, the patients, and the staff in a professional manner.

Minimum Education Required:

• High school graduate or equivalent.
• CPC Certification

Preferred Qualifications:

1. Two (2) years’ experience in a medical billing position

DISCLAIMER

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be asked to perform other duties as required and the responsibilities of the position may change.