Billing and Coding Specialist

Maryland University of Integrative Health Laurel, MD
Maryland University of Integrative Health (MUIH) is one of the leading academic institutions for integrative health in the nation. For nearly 40 years, MUIH has educated and informed leaders in health and wellness through transformative and relationship-centered programs that draw from contemporary science and traditional wisdom. MUIH offers graduate degrees and certificates in a wide range of natural medicine disciplines, both on campus and online. MUIH's on-site Natural Care Center (NCC) offers compassionate and affordable healthcare from clinical interns and professional practitioners.

Our commitment to diversity makes our organization stronger and is central to fulfilling our mission as healers. As we open ourselves to a variety of viewpoints and experiences, we naturally become more compassionate and better able to address complex problems in our community, our nation, and the world. Deepening our understanding and caring for all people propels our commitment to addressing health care disparities and reaching underserved populations with integrative health care.

Under the direct supervision of the Director of Operations for Clinical Services, the Billing and Coding Specialist is responsible for managing and processing collections, payments and special funds for all clinical services held in the Natural Care Center. Serves as the representative for answering payment, billing and insurance questions from clinical interns, private care provider, patients and insurance companies. Serves as the liaison for the processing of all special funds.

The Billing and Coding Specialist strives to uphold and promote the values of MUIH in all outreach, which include community, mindfulness, integrity, inquisitiveness, and discernment.

Essential Functions

* Provide high level of customer service to all clients/patients, clinical faculty supervisors, private practice providers, clinical interns and University administration.

* Maintain a clean, safe and professional atmosphere throughout the clinic

* Maintain a high level knowledge of and ability to apply federal HIPAA and OSHA regulations as it relates to all patient management and clinical operations support.

* In collaboration with the Director of Clinic Operations, ensure appropriate coordination of billing processes and activities to support an exceptional experience for teaching clinics, private providers and licensees

* Serve as an educator/trainer for billing related topics

* Serve as a liaison for teaching clinics special funds for patients, clinical supervisors and students

* Actively participate in team meetings that affect clinic operations and billing processes

* Provides timely submission of billing and monitoring all collections and payments in the teaching clinics and private provider care practices and licensee relations

* Collects and maintains billing and fund related metrics on NCC dashboard

* Maintain strict confidentiality

Insurance Billing and Coding

* Obtain pre-authorizations as required for certain services

* Check eligibility and benefit verification

* Review patient bills for accuracy and completeness and obtain any missing information

* Prepare, review, and transmit claims, including electronic and paper claim processing

* Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid

* Follow up on unpaid claims within standard billing cycle timeframe.

* Check each insurance payment for accuracy and compliance with contract discount

* Call insurance companies regarding any discrepancy in payments if necessary

* Identify and bill secondary or tertiary insurances

* All accounts are to be reviewed for insurance or patient follow-up

* Research and appeal denied claims

* Answer all patient or insurance telephone inquiries pertaining to assigned accounts

* Set up patient payment plans and work collection accounts

* Update billing software with rate changes

* Updates cash spreadsheet, runs collection reports

* Prepare and review patient statements

* Review delinquent accounts and call for collection purposes

* Process payments from insurance companies

* Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding

* Know several different coding systems, including Level 1 HCPCS and Level 2 HCPCS.

* Follow up to see if a claim is accepted or denied.

* Prepare appeal letters to insurance carriers when not in agreement with claim denial. Collect the necessary paperwork to support the appeal.

* Post charges and completion of claims to payers in a timely fashion.

Student Teaching Clinics

* Providing daily collection and processing of payments rendered for student teaching clinics that include preparation of the clinic billing box, reconciliation of deposits and daily end of day report

* Preparing insurance statements and insurance reimbursement support for student teaching clinics

* Verifying all patient financial accounts as part of the clinic check out process for clinical interns

* Processing all special fund applications used by student teaching clinics

* Maintain and submits monthly reporting of all payments of student teaching clinic services

Private Provider Care Practices

* Providing daily collection and processing of payments rendered for individual private provider care practices, reconciliation of deposits and daily end of day report

* Collecting, posting and managing all account payments and receivable reports

* Handling patient late fee collections and unpaid accounts

* Preparing insurance statements and insurance reimbursement support for student teaching clinics

* Collect, post and manage licensee monthly rent payments and prepare monthly report

* Maintain and submits monthly reporting of all payments of private practice provider services

Other Duties

* With the community culture in mind, employee will serve on committees as needed

* Performs other duties as assigned

Education and Experience Qualifications


* Associate degree required (Bachelor's Degree in Business or related field preferred)

* 2+ years' experience as a Medical Biller in the medical or health clinic setting

* Proficiency with electronic medical records (EMR)

* Effective communication abilities for phone contacts with insurance payers to resolve issues.

* Customer service skills for interacting with patients regarding medical claims and payments.

* Ability to work independently and collaboratively within a team environment

* Able to multi-task and meet tight deadlines

Skills and Abilities:

* Polished, professional, optimistic and self-starting personality and attitude

* Highly organized individual who is detail oriented

* Advanced proficiency in Microsoft Word, PowerPoint, Microsoft Excel, Microsoft Access jj

* Advanced proficiency with medical scheduling software and billing software.

* Excellent problem-solving skills

To Apply: For best consideration, please complete the full application by June 25, 2018. Incomplete applications will not be considered.