Quad Med is seeking a Medical Biller/Coder to join our Finance Team. The Medical Biller/Coder reviews, analyzes, and codes professional/physician medical record documentation to include, but not limited to, medical diagnostic, lab, and E/M coding information in a clinic setting. This role is responsible for following the AMA guidelines using CPT and ICD-10 codes, correctly code medical records, inputting proper codes into EMR – Epic, to reflect proper coding requirements, checking patient sessions to ensure patient visits are accurately documented and coded/billed, providing feedback to provider to ensure best practice in documentation, monitoring and audit medical records to verify coding remains compliant, and correctly read and assesses medical record documentation. Additionally, Responsible for the review and submission of professional claims to third party work comp carriers as well as invoices to client for occupational health related services, claims denials and resubmissions, organizations of payer responses, payment posting from EOBs or remits and patient payment, creating and transmitting patient statements, ability to answer patient questions about accounts and provide outstanding customer service. 

Key Responsibilities

• Accurately and efficiently code records for a primary care/wellness-based practice following Standard Procedures and AMA guidelines to accurately read and code medical records using ICD-10 and CPT codes.  Input codes into EMR, Epic. 
• Complete assigned systematic checks to ensure all medical records are properly coded and recorded within EMR. 
• Query providers when needed to obtain additional information
• Work collaboratively with management to create and analyze trends 
• Identifies and analyzes coding denials
• Identifies enhancements to coding edits to reduce denials or ineffective edits.
• Batches and sends worker’s compensation claims
• Posts remittance and explanation of benefits from worker’s compensation payers
• Follow-up with insurance companies regarding denials of payment
• Initiates and writes appeals to worker’s compensation payers
• Re-bill claims when problems or issues occur that stall initial billing or result in a denial
• Request Explanations of Benefits from insurance companies for recent payments
• Researches and locates medical notes when requested by insurance companies
• Other duties as assigned or requested

Qualifications

Education: 

• High school diploma

Experience:

• Must have a minimum two (2) years current professional/clinic coding experience in Epic
• Minimum five (5)  years of professional/clinic billing experience

Certificates, Licenses, Registrations:  

• Current AAPC or AHIMA coding certification for professional services

Knowledge, Skills & Abilities:

• Strong background in medical billing and coding
• Effective written and oral communication skills 
• Strong ethics and a high level of personal and professional integrity
• A working knowledge of current medical billing, coding and collections rules and requirements 
• Ability to work in a team environment 
• Ability to work efficiently and maintain accuracy 
• A strong understanding of healthcare compliance to regulations including HIPAA, OIG, and AMA rules and guidelines 
• Proven ability to work successfully with diverse populations and demonstrated commitment to promote and enhance diversity and inclusion.