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processing of billing for services to patients in order to expedite remittances and minimize outstanding accounts. Completes claim check process to produce bills and enters, corrects, or reverses charges when necessary with.

Works under the supervision of the Business Services Coordinator. Performs diverse clerical tasks involved in processing of billing for services to patients in order to expedite remittances and minimize outstanding accounts. Checks for prior stays and charges. Resolves questions through written correspondence, in person or by telephone. Performs other duties as assigned 1. Greets patient and public politely. 2. Composes and types letters. 3. Verifies information/charges on patient account for accuracy, reconciles discrepancies. 4. Maintains records and files account transaction, hard copy and computer system. 5. Answers inquires accurately and courteously by phone or in person. 6. Observant of co-members desk when vacant. 7. Enters detailed comments into the computer. 8. Obtains documents from outside departments to obtain required or necessary information to complete verification/billing process. 9. Checks admissions for prior stays and transfers charges from outpatients (if applicable). 10. Receives, interprets and processes any incoming mail/bulletins, submits necessary modifications if applicable 11. Processes late charges and completes spreadsheet if applicable. 12. Downloads claims to PC from Host systems if applicable. 13. Bills both primary and secondary insurance carriers for inpatients and outpatients, process required adjustments, calculates days and deductibles if applicable, at the time of billing calculates expected payments, and adjusts balances. High school diploma or GED (Required) <ul><li>14. Rebills accounts when necessary. 15. Maintains a system for review and follow-up on un-paid claims. Files liens when necessary. 16. Completes claim check process to produce bills and enters, corrects, or reverses charges when necessary with required documentation. 17. Refers accounts to a self pay status when collection efforts have been exhausted or denied 18. Interprets for Non-English speaking patients/public. 19. Communicates with insurance carriers to ensure coverage for services provided </li></ul>

APN Software Services Inc

Insurance Clerk

Administrative Skills

Billing

Business Services

Claims Processing

Computer Systems

English Language

File Maintenance

Insurance

Liens

Medical Billing

Organizational Skills

Outpatient Care

Patient Care

Presentation/Verbal Skills

Reconciliation

Record Keeping

Systems Maintenance

Writing Skills

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This role will be responsible for reviewing and accurately coding office, hospital, and surgical procedures for reimbursement, as well as ensuring accurate and compliant medical coding for both inpatient and outpatient services, diagnostic tests, and other medical services rendered to each patient. -Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient and/or outpatient medical records according to established coding guidelines.

Position Summary: Under the direction of the Coding Compliance Manager, the OP Ancillary/Physician Coder will play a key role in reviewing and analyzing billing and coding for charge processing. This role will be responsible for reviewing and accurately coding office, hospital, and surgical procedures for reimbursement, as well as ensuring accurate and compliant medical coding for both inpatient and outpatient services, diagnostic tests, and other medical services rendered to each patient. Essential Duties: -Possess analytical skills. -Possess critical thinking and problem-solving skills. -Solid understanding of the health care revenue cycle. -Strong communication skills with the ability to communicate information accurately and clearly. -Provide excellent customer service. -The ability to manage interpersonal relationships and effectively communicate with clinical partners and fellow business center teams. -Detail oriented. -Strong work ethic, honest, and dependable. -Collaborative team player with the ability to adapt to the ever-changing healthcare environment. -Professional demeanor at all times. -Maintain patient confidentiality. -Maintain a safe and orderly work area. -Personal time management skills – the ability to organize, prioritize, and multitask. -Achievement of productivity standards as established by management. -Achievement of quality standards as established by management. -Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient and/or outpatient medical records according to established coding guidelines. -Follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing/coding improvements. -Participate in developing, implementing, and reviewing programs for coding compliance monitoring, criteria for benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs. -Optimization opportunities include, but are not limited to, work in the Follow-Up and Claim Edit work queues and analyzing denial trends. -Follow Coding Compliance department branding standards when communicating with clinical partners and fellow business center teams, and work collaboratively with Physician Billing Services -Insurance and Customer Service Representatives to solve billing and coding issues. -Perform monthly coding change report analysis/oversight on provider coding change trends and communicate/educate providers, as needed. -Work weekly Missing Charge Reports to identify missed billable charges to maximize reimbursement. -Be at work and be on time. -Follow company policies, procedures and directives. -Interact in a positive and constructive manner. -Prioritize and multitask. -Other duties as assigned. Required Skills & Experience: -Three (3) years’ experience working in a hospital or physician’s office as a medical coder and interacting with physician. -Expert knowledge of ICD10, CPT and HCPCS. -Strong knowledge of medical terminology, anatomy and physiology. -Proficient Microsoft skills. Preferred Skills & Experience: -Epic software experience. Required Education: -High school diploma or GED. Preferred Education: -Associate's degree. Required Certifications & Licensure: -CPC, CCS or equivalent certification offered by the AAPC and AHIMA. <ul><li><ul><li>Must reside in California (role will transition to FTE)</li><li>Minimum 3 years of experience as a physician/professional fee coder</li><li>Strong expertise in diagnostic radiology coding and bundling rules</li><li>Radiology experience required</li><li>Knowledge of charge submission within EPIC</li><li>ProFee coding only – No HCC coders</li><li>CPC or CCS cert required</li></ul></li></ul>Position Summary:

APN Software Services, Inc. Jobs in the United States

APN Software Services Inc

APN Software Services Inc