Medical Billing Coding Specialist - TEKsystems

Location:

• Appleton, WI

Hours:

• 36 hours a week, M-F

Description: The Medical Billing and Coding Specialist is a key position in the Revenue Cycle that manages the claim process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries/correspondence. This position will assist in the clarification and development of process improvements and inquires, assure payment related to patient services from all sources are recorded and reconciled timely to maximize revenues. Other important duties include coding, credentialing, and resolving claim issues and denials.

• Evaluate medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflects and supports visits and to ensure that data complies with legal standards and guidelines.
• Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct codes.
• Reviews all claims for completeness and accuracy before submission to minimize claim denials
• Educates and advises staff on proper code selection, documentation, procedures, and requirements
• Submits claims to a variety of payment sources, including Medicaid and Medicare, and other third-party payers. Prepares, reviews, and transmits claims using EPIC, including electronic and paper claim processing.
• Maintains communication with patients and third-party payers until accounts are paid or referred to another appropriate agency for further collection activity.
• Posts payments from both patients and third-party payers to patient accounts
• Verifies insurance reimbursements for accuracy and compliance with contract discounts
• Contacting insurance companies regarding any discrepancies and or denials
• Handles patient inquiries as well as questions from other staff and insurance companies
• Identifies and resolves any patient billing related problems, denials, and insurance company follow up
• Oversee patient accounts and process refunds as necessary
• Audits current procedures to monitor and improve the efficiency of the revenue cycle by making recommendations for process improvement (billing and collections operations).
• Analyzes trends impacting charges, coding, collection, and accounts receivable and makes recommendations for improvement.

Additional Skills & Qualifications:

• Associates degree in accounting, business, finance, medical billing, or related field, preferred. Also preferred is experience with an electronic medical record system, especially Epic.
• Two (2) years Medical Insurance/Healthcare Billing, Prior Authorization and Collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations. A combination of education and experience will be considered.
• Experience working with a variety of medical payers including Medicare, Medicaid, and commercial insurance
• Experience working with EPIC
• Working knowledge of CPT, ICD-9 & ICD-10, ANSI coding systems; coding certification preferred, but not required

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.