The Biller Coder assigns diagnoses and procedure codes to patient records for services rendered. Submits claims and statements to third-party payers and guarantors. Maintains correspondence regarding billing questions and field calls from patients regarding statements.
Verifies accuracy of patient’s insurance company name/address. Sends original claims along with any supporting documentation to insurance companies.
Runs daily batch report for billing and balances to daily schedule of fees charged.
Loads correct forms into printer and prints insurance claims; submits claims electronically when accepted by payor.
Determines need for any supporting documentation required by the insurance company/case and copies documents for inclusion with claim form.
Submits claim to patient’s secondary insurance (including primary carrier’s EOB) after receiving correct payment from primary carrier.
Verifies accuracy of insurance payments received/posted.
Assigns correct ICD-10-CM code to all diagnoses and correct ICD-10 PCS code to all procedures documented in the medical record.
Assesses documentation to ensure it is adequate and appropriate to support the diagnoses and procedures to be coded.
Receives all calls and correspondence related to patient bills, whether from patients or insurance companies. Answers billing questions in a clear and polite manner; pulls business charts/computer files as necessary to answer questions.
Follows up with collections representative or business office manager on any problem claims regarding coding/supply charges.
Experience:
1-year Third Party Payer Coding experience required.
2 years preferred.
Skills and Abilities:
Must be able to work on complicated accounts by diligently pursuing the reasons for lack of or incomplete payment.
Must be able to identify the proper persons to assist with the problems.
Must understand the priorities in which patient accounts need to be worked and proceed accordingly.
Must understand contracts, contract language, and maintain good working relationships with payors.
Certificates/Licenses/Registration
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Associate (CCA)
St Augustine, Florida
Full Time