- - OAL Business Office
- PA, USA
- Full Time
The Coder bills insurance companies for services rendered by the Orthopedic Associates of Lancaster following applicable payer and governmental guidelines.
Essential Job Functions
- Promotes the mission, vision, and core values of the Orthopedic Associates of Lancaster.
- Prepares and submits professional provider claims to insurance carriers either electronically or by hard copy billing within authorized time to assure compliance with departmental standards of charge lag and resolution.
- Follows up with the clinical team for any documentation that is insufficient or unclear.
- Assists AR team to ensure that correct diagnosis/procedure codes are reported to insurance carriers.
- Keeps updated on all billing and benefit changes for insurance carriers.
- Monitors claims for missing information, appropriate documentation, authorization numbers, payer-specific modifiers, and overall coding accuracy.
- Research accurate coding and rules for cases where coding is complex or unusual.
- Maintains confidentiality of all information.
- Attends monthly Coding and Business Office Meetings and reports issues as appropriate.
- Outstanding positive attitude
- Ability to fluently use Microsoft Office including but not limited to Excel, Outlook, and Word
- Ability to multi-task
- Fast and accurate typing skills
- Ability to utilize online payer-specific manuals and medical policies
- Understand insurance claims adjudication process
- Strong organizational skills and attention to detail
- Ability to remain calm and professional
- Outstanding customer service skills
- Must be able to work in a fast-paced environment
- Uses judgment in deciding when to consult other team members and/or escalating significant issues based on the severity
- 3 years of coding experience (familiarity with current CPT, HCPCS, ICD-10 codes)
- Orthopedic coding experience preferred
- Strong knowledge of anatomy, physiology, and medical terminology
- AAPC certification preferred
- EPIC experience preferred
OAL and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. OAL and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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