Medical Biller & Coder

AIHFS is seeking a proven Medical Biller and Coder to be responsible for performing medical billing, coding, and other clerical billing duties. Reporting to the Billing Team Leader, the ideal candidate will be proficient in preparing third party insurance billing, tracking payments received, sending client statements, assisting with credentialing, monitoring aging report, and fulfilling related clerical duties.

For Full-Time employment, AIHFS offers a Comprehensive Benefit Program:

• 15 Paid Holidays per calendar year, paid bereavement, paid jury duty leave - effective immediately upon hire
• Generous Paid Combined Vacation, Sick, and Personal Leave, accrual starts immediately, able to use after 30 days
• Health, Dental, Vision and Life Insurance Coverage is available on the 1st of the Month, following 31 days of Employment.
• For Blue Cross Network HMO plan: AIHFS contributes 100% to employee premium contributions; and 50% to dependent the contributions.
• For the Blue Cross PPO plan: AIHFS contributes up to the BCN HMO amount to employee premium contribution; and 50% of the BCN HMO plan premium towards dependents.
  
• 403(b) Match Program of 50% of employee contribution, up to $5,000 per year, available after 30 days of employment.
• Educational Assistance Program, available after 1 year

For Part-Time employment, AIHFS offers the following benefits:

• Paid Holidays, bereavement, and paid jury duty leave for days and hours that fall on a scheduled work day - effective immediately upon hire
• Paid Combined Vacation, Sick, and Personal Leave, accrual starts immediately, able to use after 30 days

In addition, for Full Time Employees we are offering a Net Signing Bonus up to $800.00: with $400.00 net bonus paid upon a favorable (90) Day Performance Review and an additional $400.00 net paid bonus with continued favorable Performance Review at 270 days (9 months).

Biller Essential Duties and Responsibilities:

• Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.
• Reviews provider coding in patient management system for accuracy.
• Prepares and submits clean claims to various insurance companies electronically.
• Follows up on claims pending in the clearinghouse and ensures they are accepted.
• Follows up on third party payer denials and resubmits claims with any corrections.
• Tracks insurance and client payments received and records in patient management system.
• Prepares, reviews, and sends client statements.
• Answers billing questions from clients, clerical staff, providers, and insurance companies.
• Identifies and resolves client billing complaints.
• Ensures all providers are credentialed with insurances.
• Provides cross training to team workers, as needed.
• Punctual, reliable, and dependable with a strong work ethic and attention to detail.
• Clear, professional, and effective verbal and written communication skills.
• Completes all other assignments as directed by supervisor.

Medical Coding Essential Duties and Responsibilities:

• Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.
• Reviews provider coding in patient management system for accuracy.
  
• Unlocks visits, monitor unsigned reports, consultations/encounters and notifications within the EHR system.
• Identifies errors, inconsistencies, discrepancies and/or trends and discusses the appropriate staff, and advises modification to meet regulatory requirements in EHR.
• Maintains certifications and CEU’s as necessary
• Completes all other duties as assigned.

Agency Responsibilities

• Attends meetings as requested.
• Performs other tasks as assigned by administration.
• Exemplifies excellent customer service with patients, visitors, and other employees; shows courtesy, friendliness, helpfulness, and respect.
• Demonstrates respect for the capabilities, different cultures and/or personalities of internal and external customers.
• Relates well and works collaboratively with all levels of staff in a professional manner.
• Adapts to changing priorities and maintains professionalism under pressure.
• Takes the initiative to proactively assist others without direct supervision and to resolve problems with other departments and co-workers.

Education/Experience: A high school diploma or general education degree (GED) is required. Completion of Medical Billing and Coding certificate program is preferred. Associates degree or two years’ experience preferred.

Required Qualifications:

• Proficiency in ICD-10 and CPT coding with the ability to apply and adhere to established coding guidelines and adapt to new rules and regulations as they are implemented.
• Strong working knowledge of Microsoft Excel and medical billing and coding databases.
• Experience navigating insurance websites for eligibility verification, quality measures, and follow-up on claim denials and appeals.
• Solid understanding of billing requirements and reimbursement guidelines for Medicare, Medicaid, and commercial insurance plans.
• Knowledge of general office procedures, including answering phones, directing calls, photocopying, and faxing.
• Demonstrated ability to establish, organize, and maintain accurate filing systems.
• Commitment to promoting and supporting an alcohol-, tobacco-, and drug-free work environment.
  
• Punctual, reliable, and dependable with a strong work ethic and attention to detail.
• Clear, professional, and effective verbal and written communication skills.

Preferred Requirements:

• Certified Medical Biller
• Certified Medical Coder
• Knowledge of credentialing all provider’s and follow up on enrollment requests.
• Experience with CAQH to ensure attestations are done every 120 days.
• Experience working with Native American communities, is preferred, and respect for cultural and spiritual practices, as well as ability to work effectively with diverse populations.

Work Environment/Physical Demands:
The characteristics demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is frequently required to stand; walk; sit and use hands to finger, handle, or feel. The employee is often required to stoop, kneel, crouch, or crawl. The employee must regularly lift and/or move up to 25 pounds and frequently lift and/or move up to 50 pounds. The employee is occasionally exposed to outside weather conditions. The noise level in the work environment is usually moderate.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

NATIVE AMERICAN/AMERICAN INDIAN PREFERENCE IN HIRING WILL BE APPLIED AS DEFINED IN THE INDIAN PREFERENCE ACT (TITLE 25, U.S. CODE SECTIONS 472 AND 473).