Coding and Reimbursement Specialist
Location: Pearland Administrative Office
Department: Bus Ofc - Insurance Follow-Up
Job Type: Full Time
Kelsey-Seybold Clinic. Your Doctors for Life.
Since 1949, Kelsey-Seybold Clinic has served its patients with one goal in mind – combine the expertise of physicians in a variety of medical specialties, with the close personal care of a family doctor. Kelsey-Seybold is Houston’s largest community-based physician group, caring for more than 400,000 patients. With 19 clinic locations, we are growing to meet the health care needs of our diverse patient population. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.
Under the supervision of the Business Office Supervisor or Business Office Manager, ensures the efficient operation and effective reimbursement of third party account receivables by researching accounts, correcting provider coding as needed, abstracting information from the medical chart, and refilling or appealing claims denied for coding-related reasons, submitting additional medical documentation and tracking account status by monitoring and analyzing assigned unresolved third party accounts. Specialists will initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients. The ability to analyze, audit and reconcile an account is critical to this position.
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
Associates degree in Business Administration or related field or 2 years of equivalent experience.
2-4 years ICD 10 CPT coding/abstracting and healthcare billing and collections experience. Diversified understanding of rules and regulations of Commercial Insurance, Part B Medicare and TDH. Working knowledge of, commercial insurance, Medicare Part B and TDH Medicaid Programs.
5-6 years of experience in health care billing and collection. Knowledge of secondary or supplemental insurance claim filing (COB) is a plus. Experience with EPIC.
Certified Professional Coder (CPC) or Certified Coding Specialist –Physician Based (CCS-P) Certified Coding Associate (CCA
Understanding of EOB’s, strong PC skills. Presentation skills. Excellent written and verbal communication skills.
Displays professionalism and courtesy when communicating with patients, provider and external contacts, primarily by telephone, displaying an attitude of proven, committed customer service as well. Must be able to retain composure, meet deadlines, and appropriately analyze, research, and resolve problems in a stressful environment with constant work-related interruptions. Must demonstrate dependability and an ability to work independently