Medical Biller and Coder

Job Summary
Our Hematology-Oncology practice is seeking a detail-oriented and knowledgeable full-time Medical Biller to add to our growing Billing Team. The ideal candidate will have, at least, 1-2 years of hands-on experience in the field. Hematology/Oncology/Infusion billing experience is STRONGLY PREFERRED.

Responsibilities

• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Reviews Hematology/Oncology patient medical records and abstracts medical data to accurately capture all diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM, CPT4/HCPCS classification systems.
• Evaluate medical documentation and determine accurate E/M levels
• Ensures that CPT and ICD-10 codes are aligned so that there will be no question as to the relationship between diagnosis and treatment, and the claim will be reimbursed.
• Ensures that professional services are captured and coded in compliance with federal regulations and insurance requirements
• Assesses encounter documentation using Center for Medicare and Medicaid Services (CMS) documentation standards. Based on the provider's documentation, identify possible documentation changes that would more accurately account for services provided if implemented. Presents findings to management and works to resolve the issue.
• Follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO
• Correctly enters coding information into CureMD’s electronic medical record system.
• Ensure patient information is accurate and complete
• Identifying and billing secondary or tertiary insurances.
• Request any missing patient information
• Review referrals and authorizations
• Transfer insurance claims and billing data to billing software
• Ability to create both paper and electronic copies of documentation
• Respond to questions and complaints from patients or insurance companies
• Update and review all accounts to keep records of payments up to date
• Work with personal information and maintain patient confidentiality
• Obtaining referrals and pre-authorizations as required for procedures.
• Checking eligibility and benefits verification for treatments and procedures.
• Reviewing patient bills for accuracy and completeness and obtaining any missing information.
• Following up on unpaid claims within standard billing cycle timeframe.
• Calling insurance companies regarding any discrepancy in payments if necessary
• Researching and appealing denied claims.
• Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
• Keeps up to date on billing/coding rules, including the annual update of CPT-4 and ICD-10 codes.
• Maintains CEU’s needed for certification.

Requirements

• Certification REQUIRED: AAPC or AHIHMA - CPB, CPC, CHONC
• 1-2 years of hands-on medical billing experience in a medical office or healthcare setting
• Hematology/Oncology/Infusion billing experience is STRONGLY PREFERRED
• 1-2 years of hands-on experience using medical billing software and electronic health record systems
• Able to multitask, prioritize, and manage time efficiently
• Self-motivated and self-directed; able to work without supervision
• Excellent verbal and written communication skills
• Proficient computer skills, Microsoft Excel.
• Strong customer service skills and comfortable answering both patient and insurance company questions
• Able to analyze problems and strategize for better solutions

Note: This job description is not intended to be all-inclusive. The employee may perform other related duties as assigned to meet the organization's ongoing needs.

Job Type: Full-time

Pay: $19.00 - $24.00 per hour

Education:

• Bachelor's (Preferred)

Experience:

• Medical billing: 1 year (Preferred)

Ability to Commute:

• Howard Beach, NY 11414 (Required)

Ability to Relocate:

• Howard Beach, NY 11414: Relocate before starting work (Required)

Work Location: In person