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Medical Billing Coordinator Level 1

Company: Soft Computer
Location: Clearwater
Posted on: January 15, 2022

Job Description:

RCM Enterprise Services(RCM) exists to serve the financial billing and accounts receivable needs of our hospitals, laboratories and other healthcare testing providers as well as assisting the patient community at large with the complexities of healthcare billing. RCM provides these services utilizing sophisticated IT solutions, and world-class customer service.


The Medical Billing Coordinator Level 1 will be responsible for identifying claims that do not have charges, have not billed, and have edits based on payor requirements. Once identified, the Medical Billing Coordinator Level 1 will be responsible for obtaining the information required to resolve the errors/edits and generate a clean claim.


* Answers questions from patients, co-workers and insurance companies.
* Obtain and update patient demographic information accurately.
* Successfully works between 40 and 60 invoicing and billing errors and claim edits per day with resolution (any combination).
* Responsible for maintaining the claims queue (claim edits).
* Receive and complete any assigned billing or invoicing errors from the Level 2 team members.
* Responsible for correcting or taking next action on invoicing and billing errors and claim edits. This includes escalating complex invoicing and billing errors and claim edits to the Level 2, 3 or Medical Billing & Coding Team Lead.
* Required to contact patients for updated demographics.
* Required to contact Payors to clarify cause of edit.
* Level 1 should be faxing the information (requests for diagnosis codes, or other required documentation etc.) to clients in order to process claims
* Escalate any unanswered faxes to the Medical Billing & Coding Team Lead for resolution.
* Distribute returned faxes to Coding Team for updated diagnosis codes
* Identify trends and patterns of claims edits or errors and suggest possible system corrections to the Medical Billing & Coding Team Lead and/or Director of Revenue Cycle Management.


Education Required:

An Associate's degree in Business, Health Administration, Health Information Technology, etc. or a Medical Billing & Coding Certification is required.

Experience Required:

1 - 3 years of previous experience in a medical billing or related position is required.

Skills Required:

* Basic understanding of an explanation of benefits (EOB)
* Basic knowledge of CPT, ICD-10 and HCPCS coding standards
* Knowledge of computer programs.
* Knowledge of business office procedures.
* Ability to operate a computer and basic office equipment.
* Experience in answering a telephone in a pleasant and helpful manner.
* Ability to read, understand and follow oral and written instructions.
* Ability to establish and maintain effective working relationships with patients, clients, employees and the public.
* Must be well organized and detail-oriented.

EOE of protected Veterans and Individuals with Disabilities.

Keywords: Soft Computer, Clearwater , Medical Billing Coordinator Level 1, Healthcare , Clearwater, Florida

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