Revenue Cycle Specialist/Certified Medical Coder

  • Fairfield, NJ


: $91,400.00 - $141,030.00 /year *

Employment Type

: Full-Time


: Healthcare - Allied Health

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Vanguard has an exciting opportunity available for a?Revenue Cycle Specialist/Certified Medical Coder. This position will be located in our Corporate headquarters in Fairfield NJ and can be full-time or part-time.

Position Overview:

The Revenue Cycle Specialist/Certified Medical Coder is responsible for all facets of medical billing and accounts receivable management including charge entry, payment posting, customer service, and follow-up in profitability. You will help ensure codes are applied correctly during the medical billing process, which includes removing information from documentation, assigning appropriate codes, and creating a claim to be paid by insurance carriers. We?re looking for someone who can jump in with both feet from day one.


Job Responsibilities:

* Review all charges related to providers? professional services in the practice management system. This process should have an emphasis on accuracy to ensure timely reimbursement and maximum patient satisfaction.
* Post and balance all payments, by line-item, received for providers? professional services into the practice management system including co-payments, insurance payments and patient payments in accordance with practice protocol with an emphasis on accuracy to ensure maximum patient satisfaction and profitability.
* Provide customer service for all patients and authorized representatives regarding patient accounts in accordance with practice protocol.
* Verify all demographic and insurance information in the practice management system at the time of charge entry/claim scrubbing to ensure accuracy, provide feedback to front office staff members and to ensure timely reimbursement.
* Follow-up on all insurance claims in accordance with practice protocol with an emphasis on maximizing patient satisfaction and practice profitability using the A/R aged reports. Follow-up on all outstanding patient account balances in accordance with practice protocol with an emphasis of maximizing patient satisfaction and practice profitability.
* Provide information pertaining to billing, coding, managed care networks, insurance carriers, and reimbursements to providers, managers, and staff.
* Follow-up on all returned claims, correspondence denials, account reconciliations and rebills in a timely manner with an emphasis of patient satisfaction.
* Process refunds to insurance companies and patients in accordance with practice protocol.
* Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement with contract rates.
* Monitor the supply and quality of forms, envelopes, and supplies as required to perform job functions.
* Proficiency with all facets of the medical practice management system including patient registration, charge entry, insurance processing, advanced collections and reporting.
* Maintain information regarding coding, insurance carriers, managed care networks, and credentialing in an organized easy to reference format.
* Develop and conduct ongoing coding training to include but not limited to ICD-9, ICD-10-CM, and Medicare Risk Adjustment coding to new associates, as well as training for existing staff as needed.
* Develop and maintain coding reference tools and coding templates.
* Prepare, compile, trend, and communicate QA results to identify opportunities for performance improvement and further education.
* Provide feedback on auditing results and quality assurance results to senior management upon request.
* Note, this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change or new ones may be assigned at any time with or without notice.

Associated topics: authorization, biller, billing, coder, coding, collector, data, medical biller, medical billing, medical transcriptionist

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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