Medical Billing & Coding Specialist

COMPANY INFORMATION:

As a federally qualified health center (FQHC) Family Health Center serves all people with quality healthcare, dignity, and respect. We envision a seamless health care delivery system that is proactively responsible for the medical, dental and psychosocial needs of underserved individuals, children and families residing in Kalamazoo County.

MISSION: To provide clinical excellence with outstanding patient experience while ensuring that all members of the community have access to quality, comprehensive, patient-centered health care.

Full-Time Medical Billing & Coding Specialist

POSITION SUMMARY:

The Medical Billing & Coding Specialist is responsible for reviewing daily patient account transactions with a high level of speed and accuracy. Assists with the collection of insured accounts and maintenance of documents. Posts payments to transactions to patient accounts accurately.

DUTIES AND RESPONSIBILITIES:

• Performs insurance/patient payment posting and resolves payment transaction discrepancies with assistance from the Lead/Supervisor/Manager when necessary.
• Working knowledge of ICD-10, CPT, and HCPCS to review chart notes and ensure appropriate codes are assigned to all claims regarding diagnosis and procedures for provider services performed.
• Working knowledge of payer websites and practice management systems with the ability to recognize and resolve front/back-end claim denials from assigned payers and all others as determined necessary by the Billing Supervisor/Manager, utilizing collection procedures and adjusting of patient accounts when necessary.
• Answer patient questions regarding statements in person and through phone calls.
• Knowledge of appropriate third-party liability (TPL) and government websites (i.e. CHAMPS, WPS, Connex, Availity, HMO Medicaid websites preferred, and working knowledge of ICD-10, CPT, and HCPCS.
• Ability to use Microsoft Office, Internet, practice management system and relational database system software.
• Ability to work effectively and efficiently under tight deadlines, high volumes and multiple interruptions.
• Attend all departmental and organizational meetings as required.

COMPETENCIES:

Collaborative

• Displays willingness to make decisions, resolve conflict and delegate work assignments in a timely manner
• Adapts to change, takes responsibility for own actions to advance team goals
• Speaks and writes clearly and persuasively in formal and informal presentations
• Actively participates in meetings and uses listening skills to keep an open mind
• Solicits input from appropriate stakeholders, explains reasoning for decisions and uses strong interpersonal skills to communicate and influence others
• Gives recognition to others for results

Solid Character

• Balances team and individual responsibilities while assessing own strengths and weaknesses
• Exhibits objectivity and openness to others' views
• Welcomes feedback, builds positive team spirit, supports all team members
• Develops alternative solutions, supports and shares expertise with other team members while building positive morale
• Demonstrates knowledge of company policies and treats people with respect
• Works ethically and with integrity, uphold organizational values
• Keeps commitments, shows respect and sensitivity for cultural differences
• Educates others on the value of diversity, promotes a positive work environment where all feel free to contribute

Organizational Support

• Completes administrative tasks correctly and on time, and develops strategies to achieve organizational goals and values
• Supports affirmative action and respect diversity, understands organization's strengths and weaknesses, analyzes market and competition, and identifies external threats and opportunities while adapting strategy to changing conditions
• Prioritizes and plans work activities while understanding business implications of decisions
• Demonstrates accuracy and thoroughness within approved budget and displays original thinking and creativity
• Displays knowledge of market and competition that aligns with strategic goals
• Meets challenges with resourcefulness, generates suggestions for improving work, develops innovative approaches and ideas

Leadership

• Displays passion and optimism while exhibiting confidence in self and others
• Inspires respect and trust while motivating others to perform well and influencing actions and opinions of others
• Coordinates projects, develops workable implementation plans, includes staff in planning, decision-making, and process improvement
• Communicates and completes changes and progress of projects on time and on budget while managing project team activities to overcome resistance
• Makes self-available to staff, provides regular performance feedback
• Develops individual team member skills and encourages growth

Safety and Security

• Promotes safety precautions and security measures to ensure the safety of both staff and patients
• Adheres to data security guidelines, including appropriate use of EMR systems and IT resources

TYPICAL WORKING CONDITIONS:

• The noise level in the work environment is usually quiet to moderate.

TYPICAL PHYSICAL DEMANDS:

• While performing the duties of this job, the employee is regularly required to use hands for use of a PC as well as other office equipment.
• The employee is frequently required to stand, walk; sit and talk and use hearing to listen. The employee is occasionally required to reach with hands and arms and stoops and kneel.
• The employee must occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required by this job include close vision, color vision and ability to adjust focus.

QUALIFICATIONS:

• Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
• To perform this job successfully, an individual should have working knowledge of Microsoft Office utilizing Excel Spreadsheet software and Word processing software. Ability to use Internet, practice management system and relational database system software. Must have the ability to learn additional software to support the Accounting/Finance function.
• Ability to work effectively and efficiently under tight deadlines, high volumes and multiple interruptions.

EDUCATION/EXPERIENCE/CERTIFICATIONS/LICENSES:

• Must have a minimum of a high school diploma
• Prefer an Associate Degree in Business with emphasis in Accounting/Finance from an accredited college or university in addition to one year of experience or equivalent combination of education and experience.
• 1-2 years accounts receivable billing experience required. Areas of Family Medicine/internal medicine, preferred. PT/OT, and Behavioral Health a plus.
• Prefer knowledge of EPIC system; must have appropriate third-party liability (TPL) and government website knowledge (i.e. CHAMPS, Connex, WPS, Availity, HMO Medicaid plans).
• Working knowledge of ICD-10, HCPCS, and CPT.

Apply today to help make a difference in our community!

Family Health Center is an equal opportunity employer and reserves the right to adjust this role based on organizational needs.