Medical Billing Specialist
The Coding and Billing Specialist will be responsible for assisting and coordinating the budget process, pricing, coding, charge reconciliation, charge ticket and/or study billing plan creation, monitoring, managing denials, and medical necessity letters for clinical trials and innovative services. This position does require some travel.
Other duties as assigned.
Experience: Two to four years of experience in clinical, coding, or knowledge and/or experience in a health care setting is required. In-depth knowledge of third-party payor policies and procedures is required.
Education: Associate (or 2 yr) Degree in Business, Coding, Billing, or Clinical is required.
In lieu of degree equivalent relevant hospital experience is required. Relevant experience would include: identification of services in the hospital setting (inpatient/outpatient) of individual tests, procedures, and services based on CPT-4 and ICD-9 codes; coordinating with the clinical service area and finance to determine hospital costs, Medicare reimbursement, and total charges for related activities; identification of costs, define associated charges, creation of charging and coding processes for hospital service area procedures/activities; operational management of charges from entry to reconciliation.
Special Skills: Knowledge of Medical Terminology is preferred. Coding Certification is preferred.