Job Description

Job Description

Job Description

At Diversity Health, we are passionate about changing the face of healthcare in Middle Tennessee and Kentucky by supporting healthcare clinics such as Music City PrEP Clinic and Chosen Family Medicine. These clinics provide access to biomedical interventions and services for sexual health and wellness, as well as primary care. They serve patients with a highly skilled, competent team who dedicate their time and expertise to see patients during convenient weekday and weekend hours, and accept insured and uninsured patients with affordable, low-cost or no cost services.

Medical Billing & Coding Specialist

Job Summary

• Codes and abstracts medical record information in a timely and accurate manner utilizing the ICD10 and CPT classification system and according to established procedures. Accurately inputs information into the billing system, processes insurance claims and billing by obtaining background information and making arrangements to obtain monies owed.

General Responsibilities

• Track all aspects of billing.

• Submit and monitor all collections and payments in order to keep AR running smoothly.

• Carry out medical billing and coding work with thorough understanding of -ICD 10 , CPT codes, HCPCs, and carrier reimbursement regulations.

• Research and solve unpaid, rejected and denied claims through coordination of clinic operations and insurance requirements.

• Investigate and appeal claims when necessary.

• Initiate and answer correspondence for claims resolution with insurance carriers.

• Maintain billing accuracy.

• Update patient accounts as necessary.

• Educate providers on coding requirements.

• Answer questions from patients, staff, and insurance companies regarding medical bills.

• Routinely reconcile AR accounts and process payments.

• Obtain service pre-authorization and confirm eligibility.

• Coordinate and keep all clinician CAQH profiles and UTD Credentialing with all payers up to date.

• Participate in required staff training and meetings.

• Maintain confidentiality and adhere to all HIPAA guidelines and regulations.

• Other duties as assigned.

Job Qualifications

• Education: Certified Medical coder-Billing ( CPC and/or CPB)

• Experience: 3 years of healthcare and medical billing experience with thorough understanding of diagnostic, ICD10, HCPCS, and CPT codes

• Clear understanding of HIPAA regulations

Skills

• Excellent verbal and written communication, and attention to detail.

• Knowledge of medical billing applications.

• Knowledge of medical coding.

• Excellent organization skills.

• Knowledge of medical terminology.

• Knowledge in basic diagnosis and procedure coding.

• Proficient in Excel/Good Sheets, Word/Google Docs.

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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