The Mission of the Medical Coding and Billing Specialist To ensure proper billing, coding, and revenue cycle management. The Role: Because we are growing, we are looking for a full-time in-house Medical Biller and Coder with expertise in revenue cycle management. Who are we: We are a small Concierge Physical and Occupational Therapy Company that has experienced rapid growth in the last few years. Our patient centered focus has allowed us to grow rapidly over the last few years and we now have a great position for a skilled medical biling and coding specialist to smoothen out our revenue cycle management process. The founders of the companies work with semi-professional and collegiate athletes as well as Spine, Geriatric, TMJ/Headache, Pelvic health, Hands and Pediatric populations This is an awesome opportunity for someone who: LOVES working in a smaller and more friendly setting than a “big box” physical therapy clinic Want to work in a fast-paced, NO-DRAMA environment where office politics, backstabbing, gossip and negativity are NOT tolerated. Is extremely detail-oriented and appreciates people who take an organized, systematic approach to achieving success. Likes the idea of working for a smaller (but growing) company where their ideas and contributions directly impact the company’s success, direction and growth. Is a quick, self-motivated learner Wants a position that will offer upward earning and career advancement; we want people who are interested in growth, learning and becoming part of our team long term. Responsibilities and Activities: Collect payments from patients and vendors in a timely manner. Maintain accurate patient records by entering payments into the medical record system. File claims with insurance companies and post payments with accounts receivable. Maintain all financial records, including patient accounts, A/R, collections, journal entries, etc. Respond to patient inquiries regarding their medical bill and billing regulations. Respond to patient inquiries regarding their financial bill and financial regulatory requirements. Perform other duties as assigned by management. Communicate with management regarding patient care issues or issues that impact the overall patient experience. Communicate with management regarding patient financial or regulatory needs. Ensure compliance with medical billing regulations. Provide management with reports on-going issues that impact the patient experience. Daily claim review for accuracy and correction. Data entry of claim information, including setup of facilities and physician within billing system. Research accounts and resolves insurance verification deficiencies. Reviews and corrects patient demographics. Review unpaid and/or denied claims, appeals and follow-up on accounts to zero status. Utilize payor websites to check claim status. Ability to review and interpret explanation of benefits to patient financial responsibility Data entry of insurance allowable, payment and patient OOP on accounts. Calls patients regarding outstanding accounts. Reviews patient statements for accuracy before mailing. When requested, provide administrative support for department(s) including but not limited to performing data entry, reception duties, updating various record keeping systems, upholding company policies and Client requirements, and participating in projects, duties, and other administrative tasks. Process medical billing information for Medicare, PPOs, Workers Comp, and other health plans, including claims, invoices, and payment receipts. Ensure accurate coding, billing, and submission of claims in compliance with Medicare and health plan guidelines. Verify patient eligibility and coverage with different health plans. Conduct thorough reviews of billing data to identify and rectify any discrepancies or errors. Collaborate with insurance companies, healthcare providers, and clients to resolve billing issues and ensure timely reimbursement. Stay up-to-date with Medicare and other health plan regulations, policies, and reimbursement guidelines. Maintain comprehensive and accurate financial records related to medical billing. Generate reports on billing activities, revenue cycles, and payment trends. Assist in audits and compliance activities related to medical billing and reimbursement. Skills Required: Certified Professional Coder and Certified Professional Biller Certification Proven experience and knowledge of Medicare regulations, HMOs, PPOs, and other health plan billing requirements. Strong understanding of medical coding (CPT, ICD-10, HCPCS) and billing processes. Innate problem solver Excellent numerical and analytical skills. Meticulous attention to detail and accuracy. Strong organizational and time management abilities. Effective communication and interpersonal skills. Ability to work independently and collaboratively in a team environment. Familiarity with HIPAA regulations and patient privacy standards. Your Compensation: Competitive salary up to $45,000-$65,000 annually depending upon previous success. Health insurance benefits including dental and vision. 10 days paid vacation plus 6 major holidays off (July 4th, Memorial Day, Labor Day, Christmas, New Years and Thanksgiving). Job Types: Part-time, Full-time Pay: $45,000.00 - $65,000.00 per year Benefits: Paid time off Schedule: 8 hour shift Weekend availability Experience: CPT coding: 10 years (Required) Medical coding: 10 years (Required) Medical collection: 10 years (Required) Accounts receivable: 10 years (Required) Revenue cycle management: 10 years (Required) Medical billing: 10 years (Required) Language: Spanish (Preferred) License/Certification: Medical Billing Certification (Required) Work Location: In person