- Minimum one year medical billing experience; or equivalent combination of education and experience required.
- Must possess current coding certification as a CPC
- Must have a full understanding of aspects of medical billing.
- Must have full understanding of the various types of medical billings and ability to identify which system database should be used.
- Must be able to cross reference different types of billings to ensure consistency in the review process.
- Must possess knowledge of standard fee schedule review, UC&R review, drug and supply charges, rarity, utilization review, CPT guidelines, ICD 10, bundling/unbundling, duplicate billing and CMS reimbursement guidelines.
- Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
- Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
- Must have a full understanding of HIPAA regulations and compliance.
- Must be a qualified typist with a minimum of 35 W.P.M.
- Ability to follow instructions and respond to managements’ directions accurately.
- Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
- Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
- Must be able to work independently, prioritize work activities and use time efficiently.
EDUCATION AND/OR EXPERIENCE
High school diploma or equivalent required. Minimum one year medical billing experience; or equivalent combination of education and experience required.
CERTIFICATES, LICENSES, REGISTRATIONS
Must possess current coding certification in CPC. CPMA certification is preferred.