At Home Care Software Solutions, Inc. we realize that the whole is only as great as the parts. HCSS is a high energy and consultant-oriented company which focuses on empowering clients to reach their highest levels of operational, financial and clinical outcomes. We look for passionate learners, value leaders more than managers, and are committed to developing exceptional talent.
Medical Billing Specialist
2 - 3 years experience required
- Experience in medical billing/collections, including accounts receivable, account follow-up, claim denials, data entry and coding background is also plus.
- Posting money
- Working denials
- Contacting referring physician or agency offices for information that may be needed for claim resolution
- High school education required, advanced study preferred.
- 1-2 years working knowledge of healthcare, medical billing, government, and third party regulations a plus
- Excellent problem-solving, and communication skills
- Good computer skills, with an emphasis in internet and emailing
- Working knowledge of CPT-4 and ICD-9 coding and Medical Terminology a plus
- Candidates with home health, hospice, and/or infusion billing experience considered first
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Responsible for a variety of technical functions that requires critical thinking and problem solving skills. Functions include: review medical records and accurately code the principal and all secondary diagnoses using ICD-9-CM; sequence the diagnoses and procedures using coding guidelines; abstract and compile data from medical records to assign the most appropriate codes for optimal reimbursement. Review OASIS data to determine accuracy.
- Assigns diagnostic (ICD-9-CM) and/or procedural codes (ICD-9-CM) on all medical record types at an advanced level to ensure proper reimbursement and accurate data base information
- Audit medical records to ensure specificity of diagnoses and procedures and to ensure appropriate and optimal reimbursement
- Communicates in a positive manner with management, supervisory staff, medical staff, co-workers, and other health care personnel in order to build and maintain cooperative working relationships
- Maintains a current knowledge of regulations and legislation regarding billing compliance and documentation in accordance with regulations
- Performs other related duties as assigned.
EDUCATION: High-school diploma or GED required. Associates degree in Health Information or equivalent combination of education and experience
Three years' experience in home care coding. ART, RRA or CCS certification required
Special Knowledge, skills, abilities
- Ability to perform detail-oriented work
- Thorough knowledge of medical terminology, anatomy, physiology and disease process
- Knowledge of prospective payment system (PPS)
- Preference given to HCS-D certified candidates
- Knowledge of clinical classification systems, diagnostic related groups, and other reimbursement methodologies with the ability to identify, review, interpret, and assign correct ICD-9/10 codes
- Ability to work independently yet in conjunction with a team
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