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BAMF Health · 1 day ago

Billing and Coding Specialist

United States

Full-time

Remote

Entry, Mid Level

1+ years exp

BAMF Health is at the forefront of a revolution in Theranostics, changing lives for the better. The Billing and Coding Specialist is responsible for transferring patient and insurance information, initiating payment processes, and ensuring compliance with medical billing regulations.

Artificial Intelligence (AI)BiopharmaBiotechnologyClinical TrialsHealth Care

Growth Opportunities

Responsibilities

Collaborates with intra-departmental team on denial investigations and root cause analysis, which includes identifying opportunities for denial prevention along the revenue cycle

Maintains denial and/or audit logs and assessments in accordance with associated guidelines. Complete, thorough, and timely research and resolution of all aging, denied, rejected claims

Maintains an understanding of regulatory and payer changes to assure correct charging and billing requirements are met

Maintains working knowledge of coding and billing regulations for all payors. Keeps current on regulatory updates, local payer policies and procedures to ensure charge accuracy, compliance, and optimization

Maintains a working knowledge of applicable Federal, State, and local laws/regulations

Follows Insurance and Patient Aging for complete resolution of accounts. Account follow up includes resolving disputes with insurance companies for corrected billing. Assist with posting payments and adjustment for the Explanation of Benefits (EOB)

Utilizes coding guidelines established by the Centers for Medicare/Medicaid Services (CMS), American Hospital Association (AHA) Coding Clinic, American Medical Association (AMA), American Health Information Management Association (AHIMA) Standards of Ethical Coding, Revenue Excellence/Regional Health Ministry (RHM) coding policies

Responsible for reviewing medical records, abstracting, and analyzing physician documentation, and consulting with physicians in assigning appropriate clinical diagnosis and accurate documentation in alignment with CMS risk adjustment methodology

Qualification

Outpatient coding experienceCoding regulations knowledgeBilling software proficiencyAHIMA/AAPC certificationMedical terminology knowledgeCustomer service skillsAnatomyPhysiology knowledgeRemote coding experienceMicrosoft Office SuiteAthena

Required

Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or associate degree in health information technology or a related field or an equivalent combination of years of education and experience is required

1 year of outpatient coding experience is required