Position: Medical Billing and Coding Specialist

Reports to: Finance Team

Summary

Remedy is changing healthcare. We bring on-demand urgent care by a board-certified medical provider to your home, or phone via Video Visits. Simply pull out your phone, request a doc, and we come to you.

What’s it Like to Be Part of Remedy

Remember when doctors used to do house calls? At Remedy, we’re devoted to bringing back that kind of patient-centered and easy-to-access care. We take care of people. We are compassionate, service oriented, providing excellent care, and having a blast disrupting the traditional model of healthcare.

Job Responsibilities

  • Billing Role:
    • Reviews patient encounter for accuracy. Posts charges for encounters in a timely manner, and follows standard quality review procedures on each encounter posted
    • Responsible for charge entry posting for a variety of mediums of care (home, telemedicine visits, urgent care clinic)
    • Collection of outstanding patient balances, including establishment of payment arrangements with patients for past due balances
    • Assist patients with billing-related inquiries
    • Assist our Patient Guide Team with the verification and interpretation of patient eligibility, benefits, and/or balances
    • Follow up on unpaid, no response, rejected, and denied insurance / other payer claims regularly
    • Responsible for resolving unpaid claims that are greater than 60 days from date of service
    • Investigate any issues resulting in a payer not paying in accordance with managed care agreements
    • Posting ERA and paper insurance payments
    • Maintain confidentiality and information security of all Protected Health Information (PHI) and other confidential company information in compliance with HIPAA, HITECH, and other applicable rules, laws, and applicable policies
    • Perform other duties, special assignments, projects, reports, as assigned

  • Coding Role: Support our full-time Medical Coder with the below responsibilities:
    • Abstract pertinent information from patient records and assign the appropriate ICD, CPT, and HCPCS codes
    • Develop and maintain a deep understanding of Remedy SOPs with respect to billing commercial payers, Medicare/Medicaid, and self-funded corporate clients
    • Obtain acceptable productivity/quality rates as defined per coding policy
    • Query providers when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes
    • Maintain knowledge of and complies with coding guidelines and reimbursement reporting requirements
    • Conduct chart audits for provider documentation requirements & internal coding; provides education as appropriate
    • Comply with all legal requirements regarding coding procedures and practices
    • Submit statistical data for analysis and research by other departments
    • Verify that processed claims are accurate before patients are notified of balance due

Requirements

We will consider any candidate who might be the right fit for our team. At a minimum, we require:

  • Preferred Credential(s):
    • Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA).
    • Certified Professional Coder (CPC) credentialed from the American Academy of Professional Coders (AAPC).
  • Trained in ICD-9/10 coding, medical terminology, data management, data entry, and other administrative tasks. Familiar with various computerized coding programs and electronic health records.
  • Minimum 2 years’ coding and/or billing experience
  • An understanding of provider reimbursement practices including capitation, sub-capitation, case rates, global rates, per diems, percentage discounts, usual and customary fee schedules, RVU and RBRVS-based fee schedules, purchased repriced network, and health plan specific schedules
  • Knowledge of health insurance, HMO and managed care principles, Medicare and Medicaid claims
  • Complete work accurately, in a timely manner, and with great attention to detail
  • Superior mathematical skills
  • Commitment to high level customer service
  • Experience with ICD-10, CPT and HCPCS codes
  • Working knowledge of medical jargon and anatomy, as well as principles of HIPAA/Patient confidentiality

Compensation & Benefits

  • Full time position
  • Hourly compensation
  • Medical & Dental benefit
  • 401K
  • Partial monthly gym reimbursement
  • Healthy snacks and drinks in office