<h3>Job Description</h3>
Job Description
ORGANIZATION INFORMATION:
Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.
ESSENTIAL JOB FUNCTIONS: Essential functions of the job include, but are not limited to, medical and dental insurance understanding of coordination of benefits, claims processing, and follow up. Utilizing a computer for data entry, conducting research, electronic communications, attending meetings, drafting and distributing reports, interacting with others, reconciling data, creating and updating spreadsheets. Communicating with others is an essential job function.
SALARY: $58,700-$73,300
***MUST BE LOCATED IN OHIO***
BENEFITS:
<ul>
<li>PTO</li>
<li>Vision</li>
<li>Dental</li>
<li>Health</li>
<li>401k</li>
<li>Sick time</li>
</ul>
MAJOR AREAS OF RESPONSIBILITIES:
<ul>
<li>
Review Coding, Auditing, and billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.
</li>
<li>
Prepare and submit clean claims to various insurance companies to include both paper and electronic.
</li>
<li>
Extensive insurance follow-up and working knowledge of the appeals resolution process is required.
</li>
<li>Working in EMR system's workques to process claims per coordination of benefits</li>
<li>Review billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.</li>
<li>Responsible for contacting insurance companies and navigating insurance websites in order to secure and expedite payments.</li>
<li>Assisting in payment research in a timely and accurate manner.</li>
<li>Answer billing inquiries from patients, clerical staff and insurance companies.</li>
<li>Identify and resolve patient billing complaints.</li>
<li>Assist with patient inquiries for revenue department</li>
<li>Review assigned workques daily to ensure claims are timely</li>
<li>Evaluate patient’s financial status and rebill claims in conjunction with team and third party billing company </li>
<li>Follows and reports status of delinquent accounts.</li>
<li>Perform various collection actions including contacting patients by phone,</li>
<li>Correcting and resubmitting claims to third party payers as appropriate in conjunction with Epic/Ochin </li>
<li>Participate in educational activities and attends monthly staff meetings.</li>
<li>Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.</li>
<li>Perform other duties for Finance Department.</li>
</ul>
EDUCATION/LICENSURE:
· High school diploma, Associate’s preferred
· Medical billing certification or equivalent education on the job, formal education required.
· AAPC or other appropriate Professional Coding Certification required
· CPC, CPA, CPMA or relevant certification
KNOWLEDGE, SKILLS, ABILITIES AND OTHER QUALIFICATIONS:
· Financial management, payment processing, and/or accounting experience, and/or formal training or certification preferred
· Must have strong knowledge of CPT and ICD-10 codes and basic medical terminology skills.
· Experience with EMR (Electronic Medical Record) and medical billing software preferred.
· Knowledge of third-party operating procedures and practices, with the ability to read and process EOB’s.
· Ability to travel to multiple clinics in Ohio for trainings and meetings as needed.
· Proven record of accomplishment of exceeding goals; evidence of the ability of consistently make good decisions through a combination of analysis, experience and judgment; abilities in problem solving, project management and creative resourcefulness.
OTHER INFORMATION:
Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA

Certified Coder Medical Billing Specialist

<h3>Job Description</h3>
Job DescriptionDescription:
Summary/Objective: Obtain accurate reimbursement for healthcare claims.
Essential Functions
<ul>
<li>Reviews and resolves all assigned charges thoroughly based on coding guidelines, chart documentation and related charges in billing system.</li>
<li>Audits task manager work files with charges reviewed by Claims Manager that were found to have coding errors/omissions.</li>
<li>When appropriate communicates approved coding changes and/or questions to Physician’s and their office staff. Also alerts providers of missing or late charges.</li>
<li>Alerts management to coding trends discovered while working daily charges/edits.</li>
<li>Stays informed and up to date on coding issues by attending seminars. Possesses a comprehensive understanding of carrier specific State of Florida billing guidelines.</li>
<li>Consistently stays within the department production goal set for your area</li>
</ul>
 
Requirements:
Required Education and Experience: High School Graduate or Equivalent. Must be a certified coder either through AAPC or an equivalent organization. Certificate of ICD-10 proficiency required.
 
Preferred Education and Experience:2-3 years experience in the medical coding field. Must have a good knowledge of medical terminology, anatomy, diagnosis and procedure codes. Must be able to plan and prioritize workflow and produce an acceptable volume of work accurately. Must possess strong analytical and research capabilities to review physician and nurse documentation. Good problem solving skills and the ability to communicate clearly in writing and verbally to assigned providers and support staff.

MEDICAL CODER II - FULL TIME

<h3>Job Description</h3>
Job Description
 

Certified Medical Coder
(Remote Production Role)
Our mission to change wound care and improve the lives of others isn’t easy, but it’s worth it! One in ten residents in a skilled nursing facility will develop a skin condition requiring expert medical care. We believe that every person deserves the very best wound care. Building and leading wound care teams is how we do it! Our wound care providers bring education and encouragement to the people who take care of our patients 24/7. When they get better at their jobs, our patient’s wounds heal faster and that is our goal! 
Main Responsibilities (may include but are not limited to): 
<ul>
<li>Meet minimum production goals while maintaining accuracy requirements</li>
<li>Review provider medical coding of services rendered for medical claim submission</li>
<li>Review and respond to medical coding inquiries submitted by providers and staff</li>
<li>Work directly with providers to resolve specific medical coding issues</li>
<li>Analyze data for errors and report data problems</li>
<li>Partner with billing office to correct and resubmit claims based on review of the records, provider input, and payor input</li>
<li>Work with clinical and non-clinical groups to identify undesirable coding trends</li>
<li>Ensure claims are medically coded consistently by following CPT, ICD-10 and HCPCS rules and guidelines; escalate issues that may impact this immediately to the Compliance Committee</li>
<li>Abide by HIPAA and Coding Compliance standards</li>
<li>Collect data from various sources, maintain electronic records and logs, file paperwork, and operate office equipment</li>
<li>Accomplish other tasks as assigned</li>
</ul>
Other Duties That May be Assigned: 
<ul>
<li>Work hand in hand with partner facilities to verify resident stay status</li>
<li>Review patient information to assist in decision making process in regard to advance modalities</li>
<li>Coordinate with outside partners for advanced modalities</li>
</ul>
Skills required to succeed: 
<ul>
<li>Must live in one of the following states: WA, OR, ID, UT, AZ, TX, VA, FL</li>
<li>2+ years coding</li>
<li>2+ years medical billing experience (preferred but not required)</li>
<li>Experience with insurance and revenue cycle management processes</li>
<li>Ability to read and understand insurance EOB’s</li>
<li>Proficient in reviewing edits between CPT, ICD10, and HCPCS codes</li>
<li>Experience in reviewing insurance review denials and payer policies</li>
<li>Professional coder certification through a recognized organization such as AAPC (preferred) or AHIMA</li>
<li>Leadership qualities with the ability to effectively educate providers remotely</li>
<li>Acute attention to detail with a strong, self-sufficient work ethic</li>
<li>Excellent organization and use of time management skills</li>
<li>Ability to prioritize workload and have a strong sense of urgency when time sensitive situations arise</li>
<li>Proficient with computers and navigating within multiple applications</li>
<li>Proficient in MS Office (specifically Teams, Outlook, Excel, and Word)</li>
<li>Ability to collaborate with other UWH team members electronically via email, messaging, and telephone conferences</li>
<li>Strong verbal and written communication, as well as customer service skills; must be able to listen and communicate effectively with leadership, providers, and co-workers</li>
<li>Goal-oriented and a consistent performer</li>
<li>Must be self-motivated, punctual, dependable, and able to work independently</li>
<li>Must be trustworthy, honest and have a positive and professional attitude</li>
</ul>
Location: Remote – corporate office location in WA 
Compensation: $25.00 - $33.00 hourly - DOE and location 
This position is classified as: Hourly, Non-Exempt; Full-Time employment 
Hours: Typical hours are Monday through Friday; 7:30am – 4:00pm PST, (occasional overtime depending on claim volume) 
Benefits: 
<ul>
<li>Work remotely from a home office</li>
<li>Associates working 20+hrs per week:
<ul>
<li>Medical/Dental/Orthodontic/Vison/RX - 80% towards employee monthly premiums covered, HSA matching, dependent coverage available at employee’s expense</li>
<li>Employer Sponsored Life, AD&amp;D, and Disability Insurance </li>
<li>Voluntary Supplemental Insurance: Accident, Cancer, Critical Illness, STD, Life</li>
</ul>
</li>
<li>Paid Time Off:
<ul>
<li>Accruals up to 132hrs (16.5 days) your first year of employment based on 1.0FTE status</li>
</ul>
</li>
<li>8 paid Holidays for full-time employees</li>
<li>401(k) match on first 4%</li>
<li>Core Values that promote work-life harmony</li>
<li>Work with amazing people who have created a culture where we recognize each other’s wins and don’t tolerate gossip or drama</li>
</ul>
 Website: <a href="http://www.unitedwoundhealing.com" target="_blank">www.unitedwoundhealing.com</a>
*Do you want to grow personally and professionally by working with the best? We’d love to hear from you! Apply now: 
We are a drug-free workplace. All offers of employment are contingent upon a successful drug screen and criminal background check. EEO.

Certified Medical Coder (Remote Production Role)

<h3>Job Description</h3>
Job DescriptionDescription:
Must be able to plan and prioritize workflow and produce an acceptable volume of work accurately. Must possess strong analytical and research capabilities to review medical record documentation. Good problem-solving skills and the ability to communicate clearly in writing and verbally to assigned providers and support staff.
Follows up on open tasks/claims in accordance with established guidelines. Reviews and edit charges for accuracy of codes and modifier usage based on established billing guidelines and completeness of charges/diagnoses by specialties. Review and edit claims for completeness and compliance with billing guidelines according to payer specific policies.
Cross train in all areas within the Insurance Department. Assist Supervisor in the education of new employees.
Communicate coding changes and/or questions to provider offices and appropriate staff. Ability to communicate coding concepts to non-coding staff.
Stay informed and up to date on coding guidelines and carrier guidelines. Possess a comprehensive understanding of carrier specific, State and Federal billing guidelines. Must be skilled in writing appeals for complex coding denials.
Acts as liaison to the department to ensure any special projects and requests are completed efficiently and correctly. Acts as resource to peers.
Requirements:
Education: High School Graduate or Equivalent. Must be a certified coder either through AAPC or an equivalent organization.
Experience: 3 or more years of experience in the medical coding field. Must have advanced knowledge of medical terminology, anatomy, diagnosis and procedure codes. Experience with the claims adjudication process for multiple governmental agencies and private insurance carriers.
Additional Eligibility Qualifications
Must have at least 3 years of experience insurance claim review and appeal experience. An aptitude to retain detailed information. Ability to multi-tasked oriented, to prioritize and to produce an acceptable volume of work. Excellent organizational and problem-solving skills. Excellent communication skills, oral and written. Basic knowledge of Windows base computer applications. Accurate typing rate of 40 wpm. Ability to operate the following equipment: computer, copier, fax, web-based payer sites, and 10 key calculators.

SPECIAL ACCOUNTS REPRESENTATIVE III- MEDICAL CODER - FULL TIME

<h3>Job Description</h3>
Job Description
Job description
Busy neurology and sleep medicine practice is seeking a full-time or part-time medical biller/collector to assist the billing department with No Fault claims follow-up and appeals, arbitration preparation, and patient statements and collections. The ideal candidate should be responsible, detail-oriented, able to multitask, and have excellent computer skills; along with strong organizational, communication, and interpersonal skills.
Job Duties
<ul>
<li>Confirm receipt of electronic and paper No Fault claims</li>
<li>Review and respond to all No Fault EOBs, denials, and rejected claims</li>
<li>Appeal any unpaid or underpaid No Fault claims</li>
<li>Prepare and mail patient statements monthly; review patient accounts to ensure balances are current</li>
<li>Submit documentation for patient collections and No Fault arbitrations</li>
<li>Call patients and/or insurance carriers when additional insurance information is needed, answer incoming calls and help office staff with questions related to No Fault and patient accounts</li>
<li>Perform additional assigned tasks based on the needs of the department/office</li>
</ul>
Schedule
<ul>
<li>Full-time: 36.5-40 hours per week</li>
<li>Part-time: 20-25 hours per week</li>
<li>Flexible shifts based on the needs of the department (Monday-Friday)</li>
</ul>
Medical billing department experience is required, and experience with No Fault and/or Worker's Compensation is preferred.
Please note that this is NOT a remote position, and the employee is required to work in-house.
Company DescriptionBusy neurology office currently with one physician, two physician assistants (PA), and one nurse practitioner (NP). 
<h3>Company Description</h3>
Busy neurology office currently with one physician, two physician assistants (PA), and one nurse practitioner (NP).

Full-Time or Part-Time Medical Biller/Coder

<h3>Job Description</h3>
Job DescriptionDescription:
The Medical Coder will:
<ul>
<li>Be responsible for the day-to-day coding of specific outpatient, inpatient, emergency room, same day surgery, office, and ancillary accounts to be completed within two (2) working days of discharge. </li>
<li>Understand the importance of organization and setting priorities. </li>
<li>Demonstrate the ability to work independently without direct supervision and possess effective communication skills; and adheres to the organization’s confidentiality policy. </li>
<li>Be responsible for accurate coding of all accounts assigned according to Regulatory Coding guidelines and assure coding compliance. </li>
<li>Demonstrate attention to detail when entering codes into the hospital information system.</li>
</ul>
Opportunity for Remote Work Arrangement
Requirements:
<ul>
<li>Completion of formal coding educational program recognized by AAPC or AHIMA leading to credentials.</li>
<li>Associate degree in Health Information Technology or closely related degree (preferred)</li>
<li>Experience Coding Inpatient, Outpatient, Emergency Room, Ambulatory Surgery, Office, and ancillary services records.</li>
<li>One year coding experience with credentials.</li>
<li>Two years’ coding experience with credentials (preferred)</li>
<li>Certified Coding Specialist (CCS) from the American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Outpatient Coder from AAPC.</li>
<li>Proficient in Microsoft Office Suite (Word, Excel, Power Point, Outlook, etc.).</li>
<li>Coding/Abstracting tools</li>
<li>Ability to work independently.</li>
<li>Ability to work as part of a team.</li>
<li>Strong attention to detail</li>
</ul>

Medical Coder (Coding & Auditing) - FT/80

<h3>Job Description</h3>
Job DescriptionSalary: Depends on experience 
Destiny Management Services, LLC is a leading source of staffing services and business solutions to the Federal Government. Founded in 1996, we have provided job opportunities for more than 1000 employees nationwide in various fields.
***NOTE - THIS IS NOT A REMOTE POSITION. CANDIDATES MUST LIVE IN GUAM AND BE PREPARED TO WORK ON BASE DAILY**
 
We are looking for experienced professional medical coders for the medical treatment facility (MTF) and its geographic area of responsibility.
 
1. Experience
<ul>
<li>MSS personnel in this position are required to possess a minimum of three (3) years of medical coding and/or auditing experience in two (2) or more medical, surgical and ancillary specialties within the past 10 years. A minimum of one (1) year of performance in the specialty is required to be qualifying.</li>
</ul>
2. Other Knowledge, Skills and Abilities
<ul>
<li>Practical knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).</li>
<li>Practical knowledge of reimbursement systems, including, but not limited to, Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).</li>
<li>Practical knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.</li>
<li>Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology); and revenue cycle management.</li>
</ul>
3. Coding Certifications:
<ul>
<li>Note: A Registered Health Information Technician (RHIT) and Registered Health Information Administrator (RHIA) from AHIMA are acceptable to count for either a professional services coding certification or institutional coding certification, but not both.</li>
<li>MSS personnel in this position are required to possess a current coding certification in good standing from EACH of the following categories:</li>
<li>Professional Services Coding Certifications: The following are recognized professional certifications: Certified Professional Coder (CPC) or Certified Coding Specialist Physician (CCS-P).</li>
<li>Evaluation and Management (E&amp;M) Auditor Certification: National Alliance of Medical Auditing Specialists (NAMAS) Certified Evaluation and Management Auditor (CEMA).</li>
</ul>
Coding Test - Contractor employees must achieve a minimum 70% passing score and the candidates score must be reported in the qualification documents by the Contractor. An incumbent employee who has previously passed a test approved by the AFMS MCPO may be exempted from this requirement.
Performance Outcomes Accurately assigns diagnosis, procedure, and supply codes for the professional and institutional (facility) components of Outpatient encounters IAW DHA and AFMS MCPO completeness, productivity, and timeliness standards. Also, provides or contributes to periodic reports IAW DHA and AFMS MCPO instructions and timelines.
4. All Coding Personnel 
<ul>
<li>Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding.</li>
<li>Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided.</li>
<li>Maintains technical currency through continuing education and training opportunities.</li>
<li>Reviews encounter and/or record documentation to identify inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal re-percussions or impacts quality patient care. Identifies any problems with legibility, abbreviations, etc., and brings to the providers attention. May perform assessments and examine records for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained. Develops and submits a written (electronic or hard copy) query IAW DHA or AFMS MCPO guidelines to the provider to request clarification of provider documentation that is conflicting, ambiguous, or incomplete in regards to any significant reportable condition or procedure. Monitors query submission, response times, and completion. Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance. Assigns accurate codes to encounters based upon provider responses to queries and reports queries and responses IAW DHA or AFMS MCPO guidance.</li>
<li>Acts as a source of reference to medical staff having questions, issues, or concerns related to coding. Responds to provider questions and provides examples of appropriate coding and documentation reference(s) to provide clarity and understanding. Based on contacts from the medical staff identifies training opportunities and works with coding training personnel to focus on consistency and clarity of coding advice provided. Collaborates with Medical Coding Trainers in developing, delivering, and monitoring initial and annual coding training to providers and clinical staff by providing guidance to professional and technical staff in documentation requirements for coding.</li>
<li>Supports DHA and AFMS coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guides</li>
</ul>

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