The Billing & Coding Clerk is responsible for the accurate and timely filing of all medical claims. This position will also assist with denied and unpaid claims. The Billing & Coding Clerk must assist the Revenue Cycle Manager with all aspects of billing and collections of the center's revenue and assure that MedCura Health's revenue objectives are met for each fiscal year.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/ Experience/ Skills

• Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT), or two years billing and coding experience.
• Knowledge of electronic billing, payment posting and claims appeal process.
• Must be computer knowledgeable and demonstrate knowledge of medical software

Language Ability

• Ability to communicate effectively in a team
• Ability to speak effectively in front of large

Math Ability

• Basic mathematical

Reasoning Ability

• Ability to multi-task and
• Demonstrate good judgment, discretion in dispensing potentially sensitive information, and decision-making skills.
• Strong business ethics and compliance, conflict resolution, initiative and problem-solving
• Excellent communication, analytical, organizational and customer service

Excellent phone etiquette.

All duties to be performed according to the established standard and in compliance with all company policies and procedures while maintaining company standards:

• Adhere to MedCura's financial policies and procedures.

• Generate and process claims from provider documentation to submit claims to appropriate payer in accordance with Medicare, Medicaid, Managed care, and commercial insurance policies for proper reimbursement.

• Properly assigns and correct as warranted procedure, modifier and diagnosis codes supported by provider documentation. Appropriately queries provider for clarification or additional documentation needed for processing a clean claim.

• Review and resolve denials, research and ensure corrections are made on denied claims due to missing or incorrect information. Follows up with appropriate party as warranted regarding denials and payments.

• Assist providers with updates and training on proper coding.

• Assist with billing questions from staff, providers, and patients.

• Keep abreast of all changes in the rules and regulations applicable to, International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT), and Health Common Procedural Coding (HCPC) codes to maximize reimbursement, Risk Adjustment.

• Keep abreast of all changes in the rules and regulations applicable to Medicaid, Medicare, and other third party payers.

• Submit daily, weekly, and monthly financial reports requested by the Revenue Cycle Manager. 

• Attend staff meetings as required .