Coding and Reimbursement Specialist at Kelsey-Seybold Medical Group in Pearland, Texas

Posted in Other 23 days ago.





Job Description:

Overview

Coding and Reimbursement Specialist

Location: Pearland Administrative Office

Department: Business Office

Job Type: Full Time

COMPANY PROFILE

Kelsey-Seybold Clinic. Changing the Way Health Cares.

Kelsey-Seybold Clinic is Houston's premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey. With more than 21 clinic locations and more than 400 physicians, Kelsey-Seybold provides medical care in 55 medical specialties and is home to a nationally accredited Breast Diagnostic Center, Endoscopy Center, Infusion Center and Cancer Center. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.

JOB SUMMARY

Under the supervision of the Business Office Supervisor or Business Office Manager, ensures the efficient operation and effective reimbursement of third party account receivables by researching accounts, correcting provider coding as needed, abstracting information from the medical chart, and refilling or appealing claims denied for coding-related reasons, submitting additional medical documentation and tracking account status by monitoring and analyzing assigned unresolved third party accounts. Specialists will initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients. The ability to analyze, audit and reconcile an account is critical to this position.

EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS

(A = basics; B = preferred)

Education

A.

Associates degree in Business Administration or related field or 2 years of equivalent experience.

B.

Experience

A.

2-4 years ICD 10 CPT coding/abstracting and healthcare billing and collections experience. Diversified understanding of rules and regulations of Commercial Insurance, Part B Medicare and TDH. Working knowledge of, commercial insurance, Medicare Part B and TDH Medicaid Programs.

B.

5-6 years of experience in health care billing and collection. Knowledge of secondary or supplemental insurance claim filing (COB) is a plus. Experience with EPIC.

Licenses

A.

Certified Professional Coder (CPC) or Certified Coding Specialist -Physician Based (CCS-P) Certified Coding Associate (CCA

B.

Special Skills

A.

Understanding of EOB's, strong PC skills. Presentation skills. Excellent written and verbal communication skills.

B.

Other

A.

Displays professionalism and courtesy when communicating with patients, provider and external contacts, primarily by telephone, displaying an attitude of proven, committed customer service as well. Must be able to retain composure, meet deadlines, and appropriately analyze, research, and resolve problems in a stressful environment with constant work-related interruptions. Must demonstrate dependability and an ability to work independently

B.

WORKING ENVIRONMENT

Office