About This Role
The medical coder translates patient diagnoses and other medical information into medical code, ensuring accurate billing of claims using various classification systems. The role involves reviewing patient records and handling insurance claims.
Responsibilities
- Review patient records to verify and audit diagnoses and procedure codes submitted by providers
- Utilize ICD-10 coding principles and coding guidelines to code visits, ensuring maximum reimbursement
- Audit charges, making sure proper billing procedures are followed
- Perform coding and entering charge information into a database
- Complete billing processes
- File insurance claims
- File, retrieve, and review Explanation of Benefits forms (EOB), remittances, correspondence, and claims
- Decide on actions for payment problems, such as resubmitting claims or billing patients
- Collect all insurance information from patients and correctly input insurance data into the computer
- Determine and verify appropriate demographics (patient name, date of birth, address, insurance coverage/information, financial class, and responsible party-guarantor) to maximize timely reimbursement
- Communicate with and establish positive relationships with internal and external customers to problem solve, explain policies and procedures, and explain financial processes (i.e., co-payments, referrals, address verification) to maximize timely reimbursement
- Assist patients with questions regarding their accounts on insurance claims
- Assess accounts receivable to identify errors and determine appropriate methods of problem resolution
- Provide billing customer service in person, by phone, or correspondence by analyzing and researching patients’ accounts to provide accurate, timely information and ensure resolution that meets federal, state, and payer regulations
- Handle Worker’s Compensation claims
- Provide courteous reception assistance to patients and other staff to promote and ensure customer satisfaction
- Act as an ambassador for the facility, appropriately representing the UND Center for Family Medicine and its counterparts
Requirements
- Demonstrated comprehension of insurance claims processing, Estimate of Benefits forms (EOB), and denials
- Knowledge of medical office procedures, coding, and the ability to examine documents for accuracy and completeness
- Ability to process patient and public inquiries with poise and efficiency
- Ability to recognize, evaluate, and resolve problems and correct errors
- Knowledge of registration procedures, extensive computer skills, basic knowledge of system applications, and billing systems
- Maintains strict confidentiality in regard to all information acquired in course of performing the job
