Medical Billing Specialist

Job Summary :   Under indirect supervision, audit medical charges and record for compliance with federal coding regulations and guidelines ensuring that medical billing is correct and conforms to legal and procedural requirements; ensure the integrity of department billing.

Responsibilities :

• Audit billing reports to ensure patient encounters are billed and identify encounters not reported; prepare reports of findings and meet with supervisor to review results, and determine receipt of information and when necessary recreate documentation for provider / physician signature. Check encounter forms for level of service, diagnoses, faculty signature and referring physician, if required; contact clinical departments / hospitals to ensure billing problems are resolved and encounters will be coded / billed correctly.
• Compete charge entry from provider outpatient encounter forms and inpatient encounters upon completion of coding by coding company.
• Assist in facilitating KCC FIN assignment and medical record creation for patient encounters occurring outside of the McLaren Health System.
• Research, analyze and respond to inquiries regarding coding; respond to staff questions on physician queries.
• Liaise / meet with physician and other patient care providers regarding billing and documentation policies, procedures and regulations, patient notes and coding updates; obtain clarification on conflicting ambiguous or no-specific documentation.

Qualifications : Required :

Preferred :

Equal Opportunity Employer of Minorities / Females / Disabled / Veterans