Coding and Billing Specialist

Job Details

General Notes

This position is fully remote, which will require reliable internet access and a suitable workspace free from distractions. During the first 6 months, orientation onboarding, and initial training will be onsite at our Dell Medical School campus in Austin, Texas. Must have 3 years of coding and billing experience. Previous experience in Athena a plus.

Purpose :

Facilitates the revenue cycle process following patient accounts through the entire billing process after charge entry to completion of payment process working within Dell Medical School’s electronic health record (EHR). Serves as the liaison between clinical departments, Patient Financial Services, payers, and patients. Maintains accurate information regarding patient accounts receivable. The Billing Specialist works closely with the Revenue Cycle team and internal departments to resolve issues with insurance companies regarding incorrect registration information, claims processing, contract reimbursement amounts and coding issues. Discusses and collects patient balances and assisting clinical staff and patients with billing questions.

Responsibilities

Responsible for the accurate and timely resolution of professional billing claim and clearinghouse edits as well as payer rejections. Meets or exceeds established performance targets established by the Clinical Revenue Cycle Manager.

Performs root cause analysis and identifies edit trends timely to minimize lag days and maximize opportunities to improve the process and update the Electronic Health Record logic as needed. Demonstrates good judgement in escalating identified root causes and edit trends to leadership to ensure timely resolution and communication to stakeholders.

Communicates effectively with the Billing and Compliance Coders to handle the accurate and timely resolution of coding-related claim edits and appeals. Provides customer service to patients by educating them on insurance policies, billing procedures and coding issues.

Assist in Month End procedures and reporting. Maintains working day-to-day knowledge of the electronic health record (EHR). Thoroughly researching reasons for denied claims and working appeals as necessary to resolve outstanding balances. Identifying and documenting new payer denial trends, and notifying supervisor for escalated follow up.

Assisting with managing patient and payer credit balances with established policy and procedures. Assist with the implementation of special billing projects, as needed. Other duties and special projects as assigned related to billing and collections.

Required Qualifications

• High school diploma, GED, or equivalent is required.
• Minimum of 3 years of medical billing experience in Orthopedics, radiology or multi-specialty required.
• Previous experience working with an electronic health record (EHR) software.
• Thorough knowledge of the entire claims billing process.
• Capable of communicating effectively with patients and the health care team, including the ability to explain billing procedures and insurance benefits to patients.
• Knowledge of and / or experience with billing and collecting from Medicare, Medicaid, commercial, and managed care insurance plans.
• Knowledge of insurance agency operating procedures and practices.
• Ability to communicate effectively with payers, providers, and the clinical operations teams.
• Professional verbal and written communication.
• Must respect the confidential nature of medical information.
• Capable of following established departmental procedure, using experience and judgement to plan and accomplish goals.
• Proficient use of computers and a working knowledge of Microsoft Office.
• Able to read and interpret documents such as charts, safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to write routine reports and correspondence.
• Ability to function in a fast paced environment, including flexibility with assignments and multi-task skills.
• Ability to demonstrate problem solving skills in dealing with billing and collections related issues.

Preferred Qualifications

Previous coding experience in a large multi-specialty academic practice. Certified Professional Coder (CPC) certification from the American Academy of Professional Coders (AAPC) is preferred. Previous experience with Athena

Salary Range

50,000+ depending on qualifications

Working Conditions :

Work hours are variable based on patient care needs;

Standard office environment (remote)

Repetitive use of a keyboard

Required Materials

Resume / CV

3 work references with their contact information; at least one reference should be from a supervisor

Letter of interest

Important   for applicants who are NOT current university employees or contingent workers :  You will be prompted to submit your resume the first time you apply, then you will be provided an option to upload a new Resume for subsequent applications. Any additional Required Materials (letter of interest, references, etc.) will be uploaded in the Application Questions section; you will be able to multi-select additional files. Before submitting your online job application, ensure that ALL Required Materials have been uploaded. Once your job application has been submitted, you cannot make changes.

Important for Current university employees and contingent workers :  As a current university employee or contingent worker, you MUST apply within Workday by searching for Find UT Jobs. If you are a current University employee, log-in to Workday, navigate to your Worker Profile, click the Career link in the left hand navigation menu and then update the sections in your Professional Profile before you apply. This information will be pulled in to your application. The application is one page and you will be prompted to upload your resume. In addition, you must respond to the application questions presented to upload any additional Required Materials (letter of interest, references, etc.) that were noted above.

Employment Eligibility :

Regular staff who have been employed in their current position for the last six continuous months are eligible for openings being recruited for through University-Wide or Open Recruiting, to include both promotional opportunities and lateral transfers. Staff who are promotion / transfer eligible may apply for positions without supervisor approval.

Retirement Plan Eligibility :

The retirement plan for this position is Teacher Retirement System of Texas (TRS), subject to the position being at least 20 hours per week and at least 135 days in length.

Background Checks :

A criminal history background check will be required for finalist(s) under consideration for this position.