Medical Biller​/Coder

Panorama Pediatric Group – Medical Biller/Coder

Medical Biller & Coder

Location:

Panorama Pediatric Group – 961 Panorama Trail S, Suite 1, Rochester NY 14625

Pay: $18.50 - $27.50 per hour

This is an on-site position, not remote.

We are seeking an experienced and detailed-oriented professional to join our team and provide revenue cycle management services, including medical coding and billing, payment posting, insurance verification, provider credentialing, and other administrative support services as needed. The ideal candidate will have a strong background in medical billing and coding, along with excellent organizational and communication skills.

• Evaluates medical record documentation and encounter coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit, and to ensure that data complies with legal standards and guidelines
• Interprets medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit to accurately assign and sequence the correct ICD 10, CPT codes and HCPCS II
• Reviews Medicaid, Medicaid Managed Care, and Commercial reimbursement claims before submission for completeness and accuracy and to minimize claim denial
• Provides technical guidance to clinical providers and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to approved coding principles/guidelines
• Educates and advises staff on proper code selection, documentation, procedures and requirements
• Identifies training needs, prepares training materials, and conducts training for clinical providers and support staff to improve skills in the collection and coding of quality health data
• Measure and report trends in provider coding
• Evaluate encounters for completeness and ability to be billed
• Submit third party claims to payers for processing
• Work denials and rejections from clearinghouse and payers
• Resubmit denied claims as necessary
• Patient contact to resolve billing problem
• Aggressively follow-up on collection of aged accounts receivable
• Interact with Case Management staff on insurance problems
• Compliance activities as directed

• Post third party remittances
• Post payments received on patient accounts in a timely manner
• Work denials and rejections from payers
• Reconcile industry-specific applications to general ledger and resolve differences in a timely manner
• Post and reconcile daily cash receipt received (daily edit) to the EMR ledger (day sheet)

• Organize, update, and maintain patient medical records in compliance with HIPAA standards
• Retrieve and release records for audits, continuity of care, and insurance requests
• Support providers with documentation review to ensure completeness and coding accuracy
• Assist in transitioning or maintaining electronic health records (EHR/EMR) systems
• Prepare and submit credentialing and re-credentialing applications for physicians and mid-level providers
• Maintain an up-to-date database of provider credentials, licenses, certifications, and insurance enrollments
• Track credentialing status and ensure timely renewals to avoid disruptions in billing
• Communicate with payers, credentialing committees, and internal teams regarding application progress
• Assist with compliance audits related to credentialing and provider files

• Coordinate between clinical staff, billing departments, and external payers to streamline workflows
• Support audit preparation and ensure data accuracy across systems
• Maintain confidentiality and uphold all privacy and compliance standards
• Provide support within the Finance dept. in the event of another staff member’s absence
• Ensure patient demographics and insurance information is accurately entered in the EMR system
• Requires the ability to relate to people of diverse backgrounds, cultures, races, sexual orientations and gender identities or expressions
• Responsible for maintaining confidentiality of all patients, proprietary and protected information
• Miscellaneous filing, copying, faxing, etc. as needed to support Finance staff
• Employees are accountable for meeting performance standards. They participate in compliance audits and quality improvement plans
• Other job duties as assigned by supervisor
• Carry out these duties in a responsible, professional and ethical manner; upholding the mission and values of the Practice
• Participate in departmental and Practice-wide staff meetings and other training in-service as assigned
• Demonstrate awareness of Practice mission, organizational goals, values, policies and procedures; work effectively across departmental boundaries, represent the Practice in professional manner
• Requires the ability to relate to people of diverse backgrounds, cultures, races, sexual…