Medical Biller / Coder

Job Category: Front Office
Job Type: Full Time
Job Location: Coeur d'Alene, ID

Job description

Orthopedic Sports Institute (OSI), is a busy, orthopedic practice with locations in Coeur d’Alene and Hayden Idaho. You will work closely with our specialized and fellowship-training surgeons and other healthcare providers in a clinic setting. These include orthopedic urgent care, physical therapy, durable medical equipment (DME) departments.

With any job opening at OSI, we are looking for candidates who can not only perform the respective job duties, but also those who have a positive attitude serving the growing needs of the team and our patients. We work together, knowing that we all can always learn and grow. If you are qualified and looking for stability, working in a positive work environment, and enjoy the beauties that our community has to offer, we invite you to apply and be a part of our growing team.

Looking for someone with a professional demeanor, can work well under stress/stress situations and will provide great customer service. Under general supervision of Practice Administrator, the Physician Biller is responsible for timely submission of claims to insurance companies. Monitoring and ensuring payments for medical services are received in a timely manner. The Physician Biller may also function as an intermediary between healthcare providers, patients and health insurance companies. Includes AR resolution on aging accounts receivable in accordance with payer regulations and department policies and procedures. This position will ensure timely follow up and resolution of billed accounts using follow up worklists. The position will require contact with the patient and or payers for information and or clarification as needed to resolve account balances. This position will need advanced knowledge of payer contracts, policies and guidelines to write and submit timely appeals. The position will require timely account notation of action taken to resolve their assigned accounts.

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Job Duties:

  • Reviews patient bills for accuracy and completeness; obtains missing information.
  • Knowledge of all insurance classes, especially Medicare and Medicaid, rules and guidelines.
  • Working knowledge of CPT, HCPC and ICD10.
  • Identify insurance company or proper party (patient) to be billed; identify and bill secondary or tertiary insurances.
  • Process claims as they are paid and credit accounts accordingly.
  • Review insurance payments for accuracy and compliance with contract discounts.
  • Review denials or partially paid claims and work with the involved parties to resolve the discrepancy.
  • Manage assigned accounts ensuring outstanding/pending claims are paid in a timely manner and contact appropriate parties to collect payment.
  • Communicate with health care providers, patients, insurance claim representatives and other parties to clarify billing issues and facilitate timely payment.
  • Consult Director, team lead, team members and appropriate resources to solve billing and collection questions and issues.
  • Maintain work operations and quality by following standards, policies and procedures; escalate compliance issues to supervisor.
  • Prepare reports and forms as directed and in accordance with established policies.
  • Perform a variety of administrative duties including but not limited to: answering phones; faxing and filing of confidential documents; and basic Internet and email utilization.
  • Provide excellent and professional customer service to internal and external customers.
  • Function as contributing team member while meeting deadlines and productivity standards.

Minimum Requirements:

  • High school diploma or equivalent
  • Minimum 1 years physician clinic billing experience preferred
  • Billing certifications from AAHAM, AAPC recommended

Benefits:

  • Full-time position
  • Pay: $20 – $25 per hour
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Vision insurance
  • Life insurance
  • Paid time off

Medical specialties:

  • Orthopedics

Schedule:

  • Day shift
  • Monday to Friday

Work Setting:

  • Clinic
  • Medical office
  • In-person
  • Private practice

Ability to Commute/Relocate:

  • Reliably commute or planning to relocate to Coeur d’Alene, ID before starting work (required)

Experience:

  • ICD-10: 1 year (preferred)

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