Under the supervision of the Practice Administrator, the Mental Health Biller/Coder will register patients, verify demographics and insurance/financial information, prepares & batches all charges for charge entry and identifies proper ICD-10 & CPT-4 codes. This position requires interacting with Physicians, Nurse Practitioners, Registered Nurses and Licensed Social Workers who are generating patient encounters as well as management, other professional staff, and Insurance Company Representatives .
EDUCATION AND EXPERIENCE REQUIREMENT(S):
+ High school diploma or GED required.
+ Minimum of three years’ experience in a medical setting or an AAS in Secretarial Science with 1 year in a medical setting.
+ An understanding of Medical and Psychiatric Terminology.
+ Person should have a minimum of one-year experience coding using ICD-9-CM and CPT-4 codes.
+ Requires attention to detail with moderate volume of data entry including quality assurance.
+ Must possess excellent interpersonal and communication skills.
+ Knowledge of personal computer applications such as MS Word, Excel, Access, Outlook and Soarian billing systems.
+ Be able to multitask, with excellent organizational skills.
+ Certified coder (CPC) preferred.
PRIMARY RESPONSIBILITIES OF THE POSITION:
+ Will oversee accuracy of insurance/financial information of patients, using available resources.
+ Will Identify and bill secondary or tertiary insurances as appropriate.
+ Will Process daily charges in EMR System and data enter charge batches as needed.
+ Will insure documentation meets standards of care for billing, and communicate with providers when documentation does not meet standards.
+ Will manage the Encounter Billing Exception Worklist and related worklists that hold claims from billing.
+ Will obtain pre-authorizations as required for procedures.
+ Will follow up on unpaid claims within standard billing cycle timeframe using open encounters report.
+ Will evaluate patient records to determine that correct ICD and CPT codes are being used.
+ Will contact physicians and other health care professionals with questions about treatments or diagnostic tests given to patients with regard to coding procedures.
+ Will notify Practice Admin of any issues/trends that would result in lost revenue.
+ Will answer all patient or insurance telephone inquiries pertaining to assigned accounts, in a timely manner.
+ Will set up patient payments and collect them and run collection reports as needed.
+ Will understand and stay up to date on insurance carrier billing and payment policies.
+ Will complete Mandatory Education assignments and participate in other relevant training as assigned.
+ Willing to help with billing/charge entry at Child & Adolescent Mental Health, and Personalized Recovery Oriented Services as needed.