On the outside, Trillium Health may look like a neighborhood health center that provides accessible, affordable services to the community. On the inside, we’re focused on caring for all of an individual’s needs. “Extraordinary care, always,” is not just our noble purpose at Trillium Health, it’s our operational system. Our mission targets the complex vulnerabilities of our community, as we address the social, physical, and behavioral needs of those we serve, all under one roof.
Born from the HIV/AIDS epidemic, Trillium Health has grown into a Federally Qualified Health Center (FQHC) Look A-Like, allowing us to expand our reach and serve those who too often face barriers to care. From primary medical care, to LGBTQ affirming care, we are committed to our community. If you are interested in an organization that truly cares, Trillium Health may be for you.
We are currently recruiting for a Billing & Coding Specialist.
Works all patient and client accounts to industry-specific applications to include invoice creation, billing and posting receivables, i.e. eMD’s, Medent, AIRS, NetSmart, Scriptpro, TPMS, Trizetto, Emdeon, Ability, FundEZ. Audit all patient charts to ensure correct coding. Train medical staff on coding/billing changes. Maintain the cash receipts log, prepare deposits, complete general ledger entries, and reconciliations.
Evaluates medical record documentation and encounter coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit, and to ensure that data comply with legal standards and guidelines.
Interprets medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct ICD 10, CPT codes and HCPCS II.
Reviews Medicaid and Medicare reimbursement claims before submission for completeness and accuracy and to minimize claim denial.
Assists staff in making changes to the electronic medical record master file as required.
Provides technical guidance to clinical providers and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to approved coding principles/guidelines.
Educates and advises staff on proper code selection, documentation, procedures and requirements.
Identifies training needs, prepares training materials, and conducts training for clinical providers and support staff to improve skills in the collection and coding of quality health data.
Measure and report trends in provider coding
Evaluate encounters for completeness and ability to be billed.
Submit third party claims to payers for processing
Work denials and rejections from clearinghouse and payers
Resubmit denied claims as necessary
Patient contact to resolve billing problem
Aggressively follow-up on collection of aged accounts receivable
Interact with Case Management staff on insurance problems
Compliance activities as directed
Post third party remittances
Post payments received on patient and client accounts to eMD’s, Medent and AIRS in a timely manner.
Work denials and rejections from payers
Reconcile industry-specific applications, i.e., eMDs, AIRS, Medent, Scriptpro, TPMS, FundEZ, to general ledger and resolve differences in a timely manner
Maintain Provider insurance panels and credentialing
Assure all payer contracts are up to date and maintained
Post cash receipts (electronic) to the general ledger in a timely manner.
Prepare Bank Deposit
Balance deposits from the Pharmacy and Clinic to the general ledger
Provide support within the Finance dept. in the event of another staff member’s absence.
Requires the ability to relate to people of diverse backgrounds, cultures, races, sexual orientations and gender identities or expressions.
Responsible for maintaining confidentiality of all patient, client, proprietary and protected information.
Miscellaneous filing, copying, faxing, etc. as needed to support Finance staff.
Employees are accountable for meeting performance standards of their departments. They participate in compliance audits and quality improvement plans.
Other job duties as assigned by supervisor.
Associates’ degree in a relevant field plus 5 years’ experience in medical billing/coding. Valid Coding Certification required (CPC, CCS, CMC). Proficiency in Microsoft Excel and Word required. Must have a positive attitude, good attention to detail, be willing to take initiative and exercise good judgment. Must be reliable, highly organized and able to prioritize and juggle a variety of activities.
While performing the duties of this job the employee is required to stand, sit, walk, use hands to finger, handle, or feel; reach with hands and arms, talk and hear. Occasionally the employee must stoop, bend and lift or move up to 25 lbs. Specific vision abilities required include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.