1. Reviews health record documentation, superbill, computer generated reports and other reporting tools to identify all services and procedures performed by physicians, physician assistants, nurse practitioners, laboratory technicians, and any other provider performing billable services.
2. Assigns appropriate CPTs and HCPCS codes.
3. Assigns appropriate ICD-10 diagnosis codes selecting the codes that accurately describe the condition for which the service or procedure was performed.
4. Prepares paper and electronic claims for submission to the appropriate payer.
5. Obtains and submits copies of medical documentation as required or requested by third party payers.
6. Identifies services and procedures provided but not adequately documented in the health record. Advises office manager and provider of documentation deficiencies.
7. Analyzes and resolves claim rejections and denials related to coding issues.
8. Assists with provider billing and documentation training in daily interactions with providers and other training sessions.
9. Compiles monthly reports.
10. Identifies trends and ongoing problems related to medical documentation and recommends possible solutions.
11. Prepares, reviews, and sends patient statements
12. Answers patient questions, identifies and resolves patient billing complaints
13. Follows and reports status of delinquent accounts
14. Evaluates patient financial status and establishes payment plans
15. Other duties as advised by the Supervisor/Manager.