● Performs initial charge review to determine appropriate ICD10 and CPT codes to be used to report physician/provider services to third party payers
● Interprets progress notes, operative reports, discharge summaries and charge documents to determine services provided and accurately assigns CPT and ICD10 codes to these services
● Enters appropriate data into the billing system by selecting the appropriate codes, diagnosis, modifiers and times of start and stop of cases, anesthesiologist, and surgeon information to complete the charge process if not provided.
● Contacts providers through the management system regarding procedures and other services billed to ensure proper coding.
● Ability to work independently in a fast paced environment.
● Responsible for reviewing the billing system and other reports of clinical activity to ensure billing is captured for all patients.
● Monitors and follows up to ensure all services that can be billed are captured and coded for billing.
● Responsible for ensuring the batch processes for all coded charges.
● Reviews all providers’ documentation to ensure compliance with third party and regulatory guidelines.
● Actively works on assigned accounts receivables including review of aging to ensure 30 day follow up.
● Assists billers with denials related to coding and /or modifier use.
● Performs duties and job functions in accordance with the policy and procedures established for the department.
● Reports to work, meetings and professional obligations on time.
● Assists with other duties within the Billing department as necessary.
● Participates in meetings and trainings as necessary.
● Ensures pertinent information relating to patient accounts and/or payer interaction is documented in the billing system.
● Assists customers via phone or in person with billing questions/issues always maintain efficient and professional etiquette. All phone calls should be documented in the billing system.
● Follows up on unpaid or improperly paid claims as necessary.
● Possess understanding of revenue streams coming to practice (ie: patient payments, insurance payments, collection agency payments, IME’s, arbitration, meaningful use/PQRS, etc)
● Masters all system computer functions applicable to duties and maintains proficiency.
● Answers questions from patients, office staff, medical staff and insurance companies as needed.
● Actively participates in problem identification and resolution and coordinates resolutions with the Billing Director.
● Respects and maintain privacy and dignity of patients; assure confidentiality at all times in accordance with HIPAA regulations.
● Never “adjusts off” balance without approval from the Director of Billing.
● Participates in meetings and/or educational programs as required.
● Other duties as assigned by the Director of Billing
Education and Experience:
High School diploma or GED required. Certified Professional Coder with a minimum of 2 years’ experience with CPT/ICD 10 coding. . Good working knowledge of medical terminology and anatomy required. Experience with EMR.
The job holder must demonstrate competencies applicable to the job position.
● Knowledge of business office etiquette.
● Knowledge of grammar, spelling, and punctuation to document patient information.
● Skill in operating a computer, copier, fax, and scanner.
● Ability to speak clearly and concisely.
● Ability to read, understand, and follow oral, and written instruction.
● Ability to sort and e-file materials correctly by alphabetic and/or numeric systems.
● Ability to establish and maintain effective working relationships with patients, employees, vendors and the public
Must be willing to work in Alabang after Pandemic
Must be willing to visit Alabang office to pick up laptop before start date
Must have reliable internet connection at home
Outsourced.ph is a leading Philippines outsourcing company providing dedicated remote staff and offshore staffing services. We specialise in providing staff of the highest quality who will continue to exceed your expectations and provide benchmark offshore solutions to your business. With Outsourced you can scale your organisation quickly, easily and cost effectively with dedicated remote staff based in our modern offices in Manila.
Outsourced Quality Assured Services Inc. mission is to help our clients build successful and profitable businesses. Our team is driven by a passion for being exceptional and providing an uncompromising commitment to quality.
Our aim is to be internationally acknowledged for delivering the highest quality offshore staffing services. We aim to be the benchmark.
We hire smart and determined professionals, and we favor ability over experience. We maintain an open culture where everyone is a hands-on contributor and feels comfortable sharing ideas and opinions. We are polite and respectful, we give back to community, and we enjoy what we do.
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