This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a Medical Biller to join our team! As a Medical Biller, you will be supporting our FQHC client working closely with them to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone. Responsibilities - Assist clients with processing insurance claims through both private insurance and Medicaid/Medicare - Note and process all necessary forms from the insurance - Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures - Work with doctor’s offices and hospitals to obtain charge information and billing details - Enter all billing and payment information into the system properly and without errors - Follow up with clients and payments, as needed - Answer phones, assist clients with questions, take messages, and screen calls - Maintain the highest level of confidentiality Qualifications - Experience in revenue cycle management for FQHC facilities is a MUST - Strong customer service skills - Previous experience with medical coding or billing desired - Strong organization skills - Excellent attention to detail Benefits - 401(k) - 401(k) matching - Competitive salary - Dental insurance - Flexible schedule - Health insurance - Opportunity for advancement - Paid time off - Parental leave - Training & development - Vision insurance

• Codes inpatient and/or IRAD 90% of current FTE status. • Reviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10-CM, ICD-10-PCS, CPT, or modifier codes for each diagnosis and procedure that is identified (inpatient and IRAD). • Ensures appropriate MS-DRG assignment based on accurate ICD-10-CM and ICD-10-PCS coding assignment and medical record documentation. • Assigns hospital codes to a variety of patient classes (i.e. I/P, IRAD, etc.). • Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas. • Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals. • Assures the accuracy, quality, and timely review of data needed to obtain a clean bill. • Contacts physicians or any persons necessary to obtain information required for to accurately code assignments. Works and communicates with other offices in any manner necessary to facilitate the billing process.

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. *Now offering a $10,000 sign-on bonus that will pay out in 4 equal installments over 24 months - 6-month increments. Occ Summary The Medical Records Coder II is a certified coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Work Performed Review the complex (problematic coding that needs research and reference checking) medical records and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions. Coordinate/review the work of designated employees. Ensure quality and quantity of work performed through regular audits. Assist with research, development and presentation of continuing education programs in areas of specialization. Review medical record documentation and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM and CPT-4 coding conventions. Sequence the diagnoses and procedures using coding guidelines. Ensure DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Consult with and educate physicians on coding practices and conventions in order to provide detailed coding information. Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures. Maintain a thorough understanding of medical record practices, standards, regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Health Care/Finance Administration (HCFA), Medical Review of North Carolina (MRNC), etc. Assist with special projects as required. Perform other related duties incidental to the work described herein. Knowledge,Skills and Abilities Advanced ICD-10-CM & CPT-4 coding conventions Anatomy and Physiology Medical Terminology Extensive DRG/APC reimbursement knowledge Coding software familiarity Effective written and verbal communication skills Data entry/CRT Level Characteristics N/A Minimum Qualifications Education High school diploma required. Experience RHIA certification—no experience required; RHIT certification—no experience required; CCS certification—one year of coding experience required; CPC or HCS-D certification—two years of coding experience required Degrees, Licensures, Certifications Must hold one of the following active/current certifications: Registered Health Information Administrator (RHIA) Hospital Coding Registered Health Information Technician (RHIT) Hospital Coding Certified Coding Specialist (CCS) Hospital Coding Certified Professional Coder (CPC) Homecare Coding Specialist-Diagnosis ( Homecare Coding Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. Summary Obtains benefits and authorizations for surgical procedures, diagnostic testing, medications, outgoing referrals, and other services as part of daily operations. Determines the authorization protocols for each health plan and performs billing duties to ensure proper and timely payment is received from insurance carriers and patients. Job Duties - Collaborates with physicians and provider office staff in ascertaining the appropriate authorization based on medical necessity and the treatment plan provided. - Performs a medical necessity check to determine if procedure and diagnosis support medical necessity. - Ensures authorizations are obtained in accordance to network policy (any authorization not falling into policy guidelines is communicated to ordering office, patient, and manager). - Communicates direct/indirect with insurance companies to obtain insurance verification, benefits and precertification for approval. - Verifies additional clinical information and insurance authorizations/referrals. - Reviews and monitors WQs/schedules to ensure that proper and accurate authorization has been received prior to patient’s visit. - Maintains compliance with benchmark data regarding accounts registered versus scheduled procedures. - Determines estimated patient financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines. Minimum Qualifications - High School Diploma/GED with specialized training in insurance, coding, billing, or similar healthcare certificate programs. - 1 year in a healthcare setting with insurance verification/authorizations. - Familiarity with billing procedures and payer reimbursement. - Knowledge of patient rights and laws relative to those rights, such as HIPAA. - Proficient in utilization management processes, standards, and managed care. - Proficient in standard medical practices and insurance benefit structures. Preferred Qualifications - Associate’s Degree Physical Demands Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR. Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require. Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities. https://youtu.be/GD67a9hIXUY Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes. Work Shift: Day Shift Address: 1200 S Cedar Crest Blvd Primary Location: REMOTE IN PENNSYLVANIA Position Type: Remote Union: Not Applicable Work Schedule: Monday-Friday 8:00a-4:30p Department: 1004-13036 COH-Precertification Dept