Reports to the Supervisor, Ambulatory Accounts. Responsible for reviewing clinical documentation as appropriate to extract data and apply ICD-9 or ICD-10 diagnostic and procedural codes for billing, internal and external reporting.

Duties and Responsibilities

• Demonstrates proper telephone etiquette. Exercises congeniality.

• Review office encounters and surgery encounters to ensure proper coding before claims are submitted.

• Follow up on all denied claims.

• Collect payments and setup budgets for patients with outstanding balances

• Work daily credit reports.

• Process refunds to patients and insurance carriers when identified.

• Process CCI claim edits within the Nextgen system.

• Process denied claims within our clearinghouse Navicure. This consist of three different denials. (Navicure, Insurance and ERA's)

• Process appeals for denied claims.

• Perform other duties as assigned.
• Obtain coding certification.

• Maintain patient confidentiality.

Qualifications:

• High school diploma or GED required, and three years of previous billing experience required.
• Extensive knowledge of medical terminology, reimbursement and coding required.
• Computer data entry or word processor experience desired.
• Must have professional telephone manner.
• CPC certification preferred.