KEY FUNCTIONS & RESPONSIBILITIES:

• Research forms documenting patient visit information and making corrections to the amount due from patient and insurance.
• Provide support to the clinics and attend outside meetings if necessary.
• Audit claims, accounts, payer, and vouchers, and prepares adjustments reports to substantiate individual transactions to resolve payment issues.
• Review, investigate, and correct errors and document inconsistencies in practice management system entries, documents, and reports.
• Working knowledge of HCPCS, CPT, ICD, and revenue codes using appropriate manuals and resources, both hard-copy and online to facilitate billing.
• Meets productivity goals as set by Management.
• Recognizes and performs essential duties and aids others or performs other required tasks, as assigned by management, when own assignments are completed.
• Coordinate communications with payers to ensure accurate billing practices, enhance reimbursement opportunities, achieve cash collections targets, and reduce or maintain A/R 0ver 120 days at and below the targets level.

OTHER SKILLS AND ABILITIES:

• Certified Coder and/or Revenue Cycle Specialist preferred.
• A minimum of two (2) years of experience as a medical biller or coder, is preferred.
• Attention to detail and ability to work in a fast-paced environment
• Preferred experience/knowledge of FQHC billing guidelines and procedures
• Solid understanding of billing software and electronic medical records.
• Maintain up-to-date knowledge of insurance guidelines, Medicare, and state Medicaid
• Experience with and understanding of CPT, ICD-10 coding
• Must have the ability to multitask and manage time effectively.
• Excellent written and verbal communication skills.
• Outstanding problem-solving and organizational abilities.
• Excellent computer skills and interpersonal skills
• Knowledge of the full revenue cycle (processing claims, resolving denial, maximizing reimbursement, A/R)
• Knowledge of billing, reimbursement, and third-party regulations
• Experience with eCW, a plus
• Knowledge of healthcare governing agency policies and procedures
• Knowledge of medical terminology
• Must have good interpersonal/human relations skills
• Ability to work independently and as part of a team
• Ability to work in a fast-paced environment
• Ability to interpret accounts and records, and develop spreadsheets and reports
• Ability to perform basic bookkeeping and compile statistics
• Ability to type, and operate a personal computer and various office equipment
• Ability to prepare reports, and maintain records and files
• Ability to extract data from conversations and documents
• Ability to maintain confidentiality - ensure the privacy and security of protected health information per HIPAA requirements.
• Exhibits and promotes a standard of excellence in the performance of all duties and interactions with patients, co-workers, and outside contacts.
• Perform other duties or special projects as assigned.

EDUCATION AND EXPERIENCE:

• H.S. Diploma or equivalent is required
• Medical Billing/Coder certification, a plus
• Two (2) medical billing and coding experience, preferred
• Computer skills in Microsoft Office, excellent organizational, verbal, and written communication skills

CCI Health Services is a 49-year-old Federally Qualified Health Center is a diverse and inclusive workplace that serves 60,000 medical patients and Women Infant’s & Children (WIC) participants in Montgomery and Prince George’s Counties. As a 501(c)3 non-profit, CCI is committed to providing high-quality, affordable primary healthcare to every patient across all life stages. Visit www.cciweb.org for more information.

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