Responsible for (a) reviewing and analyzing medical billing and coding for processing and accurately coding encounters for reimbursement, (b) providing education to providers and staff on correct documentation, coding, (c) billing of visits, as well as performing audits of medical claims for compliance with federal coding regulations and (d) Assists in coding accurately all encounters received on any given day into the billing system and bill out those claims in a timely manner guidelines.

• Evaluates medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes, in addition to other documentation, accurately reflect and support the outpatient visit.
• Reviews Medicaid, Medicare, and other reimbursement claims for completeness and accuracy before submission to minimize claim denials. Ensures that all data complies with legal standards and guidelines.
• Provides technical guidance to the clinical providers and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to the approved coding principles/guidelines.
• Interprets medical information, such as diseases or symptoms, in addition to diagnostic descriptions and procedures, to accurately assign and sequence the correct ICD-10-CM and CPT codes.

1. Review denied billing, rebilling, and posting payment for correction.
2. Prepare weekly and monthly billing and AR reports and analysis of AR to identify and collect unpaid accounts.
3. Generate regular reports on denials, unlocked notes, etc., from eCW.
4. Maintains files and logs on all pending, denied, and paid claims as necessary for accurate accounts receivable documentation to follow up.
5. Educate and advise staff on proper code selection, documentation, procedures, and requirements
6. Performs other functions necessary for the proper functioning of the East Harlem Council for Human Services, Inc.
   SUPERVISED BY: Billing Manager

QUALIFICATIONS:

• Bachelor’s Degree preferred. High School graduate or equivalent required.
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credential required
• At least two (2) years of medical coding and billing experience in a healthcare setting.
• Working knowledge ICD-10-CM codes and procedures
  · Working knowledge of computers required.
  · Expert knowledge of medical billing software program is required, eCW preferred.
  · Bilingual Spanish/English preferred.
  · Excellent interpersonal and communication skills.
  · Ability to work independently and perform critical work under deadlines.
  COVID Vaccine required
  WORK SCHEDULE: Monday-Friday, 9am-5pm, 35 hours per week
  Job Type: Full-time
  Pay: $27.47 - $30.21 per hour

Benefits:

• 401(k)
• Health insurance
• Paid time off

Work Location: In perso

• Evaluates medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes, in addition to other documentation, accurately reflect and support the outpatient visit.
• Reviews Medicaid, Medicare, and other reimbursement claims for completeness and accuracy before submission to minimize claim denials. Ensures that all data complies with legal standards and guidelines.
• Provides technical guidance to the clinical providers and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to the approved coding principles/guidelines.
• Interprets medical information, such as diseases or symptoms, in addition to diagnostic descriptions and procedures, to accurately assign and sequence the correct ICD-10-CM and CPT codes