Summary:
Under supervision of the Practice Manager * MSO ensures accurate diagnostic/treatment codes for accuracy to effect prompt reimbursement for MSO services. Assesses adequacy of medical record documentation to support coding. Performs data input of encounter forms. Acts as first-line representation with patients and payors regarding billing issues.

Responsibilities:
Reviews encounter from to ensure accurate diagnostic/treatment codes are applied. Reviews codes for accuracy and specificity which result in appropriate and optimal reimbursement from payor. Assesses adequacy of medical record documentation to support related coding. Reports inconsistencies in documentation to appropriate provider.



Return all patient calls within next business day.



Denied/rejected claims resubmitted accurately and within filing deadlines of payor.



Documentation of efforts to resolve claims issues and collection of outstanding balances.



Prompt referral of uncollectible accounts to practice manager.



Provides for customer-focused service while acting as first line of communication with patients and payors regarding billing issues. Confers with third party payor representatives to resolve billing problems and ensure billing practices are current and meet the payer*s state and regulatory agency requirements. Follows up on and resolves rejected and/or denied claims.



Reviews patient accounts including self-pay delinquent and/or accounts in collection status. Researches issues conducts problem resolution makes recommendation to practice manager and/or provider for final disposition of outstanding account balances.



Active participation in the practice management team focusing on the development and implementation of billing policies and practices. Maintains current knowledge of federal and state regulations regarding medical billing practices. Acts as a resource to practice management and providers provides periodic assessment of individual and group coding practices with recommendations for improvement.

Other information:
BASIC KNOWLEDGE:

High school level of knowledge including the ability to use computer software programs that allow data entry conduct data research and develop system reports.



Completion of certification or enrollment in a formal program in medical coding anatomy and medical terminology that leads to certification in professional coding.



EXPERIENCE:

Minimum of 1 *2 years experience in a medical office setting including experience with medical billing and direct interaction with patients.



WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

A normal office environment with some exposure to patients with illnesses or injuries.

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.

Location: Management Services Org USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union