Certified Coding Specialist
Spire Orthopedic Partners
Location
Middletown, CT | United States
Job description
Job Details
Level Experienced
Job Location MSO-MOSA 512 (1400) - Middletown, CT
Position Type Full Time
Education Level High School or Equivalent
Travel Percentage Some travel between company locations
Job Shift Day
Job Category Health Care
Description Who we are: Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital, and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most - patient care. Rooted in the 100-plus-year legacy of its founding partners, the network spans the Northeast with 128 physicians, over 1100 employees, and 28 locations from Connecticut, New York, and Massachusetts.
Join the patient-centric team at Middlesex Orthopedic & Spine Associates and see how the revenue cycle team plays an integral role in providing world-class care and customer service. Thrive as a valued member of this growing team, where we are committed to excellence across all aspects of our organization.
See our website to learn about our history of providing exceptional care in central Connecticut.
What you'll do: Channel your expertise as a
Certified Medical Coder and allow your keen attention to detail shine as you take on this important role.
This position plays a key role in the efficient and effective financial operations of the practice. Join a dedicated team focused on empowering orthopedic and spine specialists to transform patient lives and to be the best orthopedic and spine network in our community.
Responsibilities/Duties: - Process claims daily and correct front-end edits timely for submission
- Reprocess rejections, and file appeals for claim denials to ensure maximum reimbursement for services provided
- Contacts insurance companies regarding outstanding insurance balances, identify what is needed for resubmission, checks eligibility, ensures authorization is on file and verifies claim status on payer websites to ensure all necessary billing information has been satisfied to resolve the account balance.
- Contacts patients for updated insurance information when necessary
- Monitors and follows up on Aging
- Communicates internal/external issues causing cash delays timely
- Answers patient calls and responds to questions timely.
- Ensures patient account billing information and account balances are accurate and makes necessary adjustments in the computer system and documents all activity taken on the account for an audit trail.
- Medical Coding - Review physician recommendations for treatments to ensure they are accurate, match the correct billing code to all surgical and non-surgical procedures, and submit documentation to the insurance company or other departments that require information.
- Research and analyze data needs for reimbursement. Analyze medical records and identifies documentation deficiencies. Serves as a resource and subject matter expert to other coding staff. Reviews and verifies documentation supporting diagnoses, procedures, and treatment results.
What we offer: - Excellent growth and advancement opportunities
- Dynamic environment
- Access to a diverse network of practitioners
- Broad infrastructure of tools and programs to enhance the employee experience
- Competitive Compensation
- Generous PTO
- Benefits package: health, dental, vision, 401(k), etc.
We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as "protected characteristics").
Qualifications Who you are: Qualifications
High School Diploma or equivalent required.
3+ years of coding/billing follow-up experience in revenue cycle functions for a large orthopedic/spine surgical practice or physical therapy, or injections or Evaluation & Management (office visits).
- Certified Professional Biller, CPB, or dual Biller Coder, CPC through AAPC , or Certified Revenue Cycle Specialist, CRCS through AAHAM, preferred
- Must be well organized, detail-oriented, and able to multitask
- Knowledge of general principles of medical billing including verification, authorization, posting charges, procedures, diagnosis, medical necessity as well as knowledge of federal, and state regulations and billing rules
- Willingness to participate in goal-setting and educational activities for own growth and advancements.
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