Medical Billing Specialist

POSITION SUMMARY

The Medical Billing Specialist calculates and collects payments for medical, dental and behavioral health procedures and services.

KC CARE CULTURE CODE

KC CARE follows a culture code in all we do. Our code determines how we work, treat each other, and move health equity forward. As an employee of KC CARE, you will:

• Put patients first, always
• Treat all people with dignity, respect, and kindness
• Create safe places for others to share their voice; encourage creativity
• Always strive for improvement; keep learning
• Own your work, action, and mistakes - no one is perfect
• Have fun - work should be fun and we want you to have fun at KC CARE

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Posts payments both electronically and manually, maintaining accurate medical billing records, and documenting revenue from patients and insurance reimbursements.
• Reviews of health documentation, superbills, and associated reporting tools to identify services and procedures provided by clinical staff.
• Assigns appropriate procedure and diagnosis codes for accurate placement for procedure.
• Analyzes and ensures patient income demographics for sliding fee scale purposes, post patient payments to accounts, and prepare electronic claims submission for associated patient.
• Assures the final diagnosis and procedures as stated by the physician are valid and complete.
• Obtains and submits copies of medical documentation as required or requested by third party payers.
• Researches and resolves claim rejection and denials related to coding.
• Assists with AR follow-up and balance clean up.
• Partners with patients to resolve questions, complaints, or concerns.

MINIMUM REQUIREMENTS

• High school degree or equivalent.
• Advanced knowledge of medical codes involving selection of most accurate and descriptive code using ICD-10, CPT, HCPCS coding conventions.
• Proven skills in correlating generalized observations/symptoms to a stated diagnosis to assign the correct ICD-10-CM code.
• Two years coding experience.

PREFERRED REQUIREMENTS

• Associates degree in any science or medical discipline.
• CCA, CCS, CCS-P CPC RHIA, RHIT or equivalent certifications.

WORKING CONDITIONS AND DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Working Conditions

General working conditions are in a healthcare facility. As such, there is a potential exposure to virus, disease, and infection from patients while performing the duties of this job. May experience traumatic situations including psychiatric traumatized and deceased patients. Travel may be expected to community meetings, client homes, or other agencies.

Physical Demands

While performing duties of this job, employees are regularly required to set, walk, and stand; talk and hear; both in person and by telephone; use hands repetitively to finger, handle, feel, or operate standard office or clinical equipment; reach with hands and arms; and occasionally lift up to 20 pounds.

Mental Demands

While performing the duties of this job, employees are regularly required to use written and oral communication skills; read, analyze, and interpret data, information and documents; analyze and solve non-routine and complex problems; use math and mathematical reasoning; observe and interpret situations; learn and apply new information or skills; perform highly detailed work on multiple, concurrent tasks; work under intensive deadlines with frequent interruptions; and interact with others outside of their department.

Duties and responsibilities, as required by business necessity may be added, deleted, or changed at any time at the discretion of management, formally or informally, either verbally or in writing. Scheduling, shift assignments, and location may be changed at any time, as required by business necessity.