Revenue Cycle Specialist II- Medical Billing and Coding Specialist

*This role is IN-OFFICE for the first 90-days, with transition to a HYBRID schedule*

Position Summary:

The revenue cycle specialist in the billing department performs complex billing functions which are integral to the revenue cycle team. Experience in medical terminology, CPT, ICD-10, modifiers, and documentation review is required. Using payer guidelines and contracts, coding guidelines, and revenue cycle support will be necessary in performing daily functions to include high volumes of electronic claim submission, auditing claims and encounters for accuracy, and resolving any errors which prevent claims from being submitted based on system rules.

THIS IS A CHARGE ENTRY/FRONT-END BILLING POSITION, NOT CLAIMS FOLLOW-UP.

Position Responsibilities:

• Reviewing ~250 encounters daily and submit claims for those encounters.
• Ensuring ICD-10 and CPT codes are accurate based on documentation.
• Attaching ICD-10 codes to their respective CPT codes and append the appropriate modifiers.
• Complying with medical guidelines and policies, as well as company guidelines and policies.
• Communicating effectively with providers when clarification is needed.
• Recognizing and reporting any trends to management.
• Identify issues attributing to claim rejections and correct as appropriate.
• Able to handle high volume while prioritizing job functions.
• Follow appropriate HIPAA guidelines.

Essential Skills and Qualifications:

• Minimum 2 years recent experience in billing/coding/charge entry for an advanced specialty (i.e. Orthopedics, Cardiology, ENT, Oncology, etc..). 
• Strong knowledge of ICD-10, HCPCS, CPT and Modifiers.
• Knowledge of Revenue Cycle Processes and Workflow.
• Ability to review and extract relevant information to assist in claim accuracy.
• Ensures compliance with medical coding policies and guidelines; understands the application of each code set.
• Works towards compliance in all aspects of coding, participates in compliance activities as requested and conducts/participates in provider coding reviews and education when required.
• Proficiency in computer skills including typing speed and accuracy.
• Ability to maintain a high level of integrity and confidentiality of medical information.
• Work well individually and in a team environment accomplishing set goals.
• Ability to prioritize and manage multiple responsibilities.
• Excellent written and verbal communication skills.
• Experience with MS Office, EMR system eClinical Works a plus.