SME Responsibilities: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and submissions. 6. Research and Resolution: Research complex billing issues and provide timely resolutions to ensure prompt reimbursement and customer satisfaction. 7. Documentation and Reporting: Maintain detailed documentation of billing processes, audits, and resolutions. Prepare reports for management on key metrics and performance indicators. 8. Customer Support: Provide support to internal teams and external clients regarding billing inquiries, discrepancies, and issues. 9. Stay Updated: Stay informed about changes in medical billing regulations, coding guidelines, and industry trends to ensure compliance and best practices. 10. Collaboration: Collaborate with cross-functional teams including healthcare providers, IT professionals, and legal experts to address billing challenges and implement solutions.
SME Responsibilities: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and submissions. 6. Research and Resolution: Research complex billing issues and provide timely resolutions to ensure prompt reimbursement and customer satisfaction. 7. Documentation and Reporting: Maintain detailed documentation of billing processes, audits, and resolutions. Prepare reports for management on key metrics and performance indicators. 8. Customer Support: Provide support to internal teams and external clients regarding billing inquiries, discrepancies, and issues. 9. Stay Updated: Stay informed about changes in medical billing regulations, coding guidelines, and industry trends to ensure compliance and best practices. 10. Collaboration: Collaborate with cross-functional teams including healthcare providers, IT professionals, and legal experts to address billing challenges and implement solutions. ** Hand on experience in ECW software preferrable**
A patient calling role in medical billing primarily involves handling communication with patients regarding their medical bills and payments. This includes tasks like making outbound calls to patients to discuss outstanding balances, setting up payment plans, and addressing billing inquiries. They also may need to verify insurance coverage, update patient information, and collaborate with healthcare providers on billing discrepancies. Here's a more detailed breakdown of the responsibilities: Core Responsibilities: Outbound Calling: Making calls to patients to follow up on unpaid bills or to discuss billing issues. Payment Processing: Accepting payments, setting up payment plans, and handling financial transactions. Insurance Verification: Confirming patient insurance coverage and eligibility. Billing Inquiries: Addressing patient questions and concerns regarding their bills. Data Management: Updating patient information and billing records in the system. Collaboration: Working with other departments, like medical coding and insurance claims processing, to resolve billing issues. Documentation: Maintaining accurate records of all patient interactions and transactions. Key Skills: Communication: Excellent verbal and written communication skills are essential for explaining complex billing information to patients. Customer Service: The ability to handle patient inquiries with empathy and professionalism. Problem-Solving: Identifying and resolving billing discrepancies and payment issues. Organization: Managing multiple patient accounts and tasks effectively. Computer Literacy: Proficiency in using medical billing software and navigating online portals. Medical Terminology: Basic understanding of medical terms and procedures to understand billing details.
SME Responsibilities: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and submissions. 6. Research and Resolution: Research complex billing issues and provide timely resolutions to ensure prompt reimbursement and customer satisfaction. 7. Documentation and Reporting: Maintain detailed documentation of billing processes, audits, and resolutions. Prepare reports for management on key metrics and performance indicators. 8. Customer Support: Provide support to internal teams and external clients regarding billing inquiries, discrepancies, and issues. 9. Stay Updated: Stay informed about changes in medical billing regulations, coding guidelines, and industry trends to ensure compliance and best practices. 10. Collaboration: Collaborate with cross-functional teams including healthcare providers, IT professionals, and legal experts to address billing challenges and implement solutions.
We are seeking an experienced Medical Coder with a strong background in Cardiology coding to join our growing team. The ideal candidate will possess deep knowledge of cardiovascular procedures and diagnostic codes, ensuring accurate and compliant coding to optimize reimbursement and maintain regulatory standards. Key Responsibilities: Accurately assign ICD-10-CM, CPT, and HCPCS Level II codes for cardiology-related procedures and diagnoses. Review and analyze medical documentation provided by physicians to ensure coding reflects the services rendered. Stay updated with changes in coding guidelines and payer-specific requirements related to cardiology. Collaborate with physicians and clinical staff to clarify documentation and resolve coding discrepancies. Maintain productivity and accuracy benchmarks as set by the organization. Assist in audits and quality assurance efforts to ensure compliance with federal, state, and payer regulations. Requirements: High school diploma or equivalent required; Associates or Bachelor’s degree in Health Information Management or related field preferred. Certification required: CPC , CCS , or CRC (AHIMA or AAPC). Minimum 2 years of experience in cardiology coding. In-depth understanding of cardiovascular procedures such as catheterizations, pacemaker insertions, electrophysiology studies, echocardiograms, and stress tests. Strong knowledge of medical terminology, anatomy, and physiology related to the cardiovascular system. Proficient with EHR systems and coding software (e.g., EPIC, 3M, EncoderPro, etc.). Excellent attention to detail and strong analytical skills. Preferred Qualifications: Experience with interventional cardiology or electrophysiology coding. Knowledge of billing compliance and payer-specific guidelines. Prior experience working in a cardiology clinic, hospital, or specialty practice.