Role Description We are a growing medical supply company seeking a detail-oriented and experienced Medical Billing & Intake Specialist to join our remote team. This role is critical in ensuring accurate billing, patient intake, and insurance eligibility verification. - Handle medical billing processes including claim submission, follow-ups, and payment posting - Manage patient intake, ensuring accurate entry of demographics and documentation - Perform insurance eligibility and benefits verification prior to service or order processing - Utilize Medact billing software (Windows-based) for all billing and intake tasks (required) - Communicate with insurance providers to resolve claim issues, denials, and discrepancies - Maintain accurate and up-to-date patient and billing records - Coordinate with internal teams to ensure smooth order processing and reimbursement Qualifications - Mandatory experience with Medact billing software (non-negotiable) - Proven experience in medical billing, intake, and eligibility verification - Strong understanding of insurance processes, claims, and reimbursements - High attention to detail and accuracy - Excellent communication and organizational skills - Ability to work independently in a remote environment - Reliable internet connection and Windows-based computer Requirements - Experience in a medical supply or DME (Durable Medical Equipment) company (preferred) - Familiarity with U.S. healthcare billing practices and insurance policies (preferred)

Role Description The Inpatient Medical Coder under the supervision of the Manager of Coding and Data Quality accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. - Analyzes inpatient cases, identifies and assigns ICD-10 diagnostic and PCS procedural codes for reimbursement, research, and compliance with federal and state regulations. - Utilizes critical thinking to analyze and evaluate documentation issues with consultation from medical and clinical staff, and clinical documentation specialists as needed. - Monitors assigned work on a daily basis to facilitate the billing process within established timeframes. - Maintains a high level of accuracy in code assignments to prevent claim denials, billing errors, and potential legal issues. - Reviews medical records, including patient histories, examination findings, diagnoses, and treatment plans, to extract pertinent information for code assignments. - Communicates with various departments within the hospitals regarding billing and registration issues. - Complies with AHIMA standards of ethical coding and coding compliance guidelines, including adherence to HIPAA privacy regulations. - Utilizes coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignments. - Participates in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials. - Performs other duties or projects such as coding corrections assigned by the manager. Qualifications - High School graduate or equivalent. - Formal ICD-10-CM and CPT training required. - Associates or Bachelor’s degree preferred. - At least two (2) years of inpatient ICD-10-CM/ICD-10-PCS coding and abstracting experience in an acute care hospital setting required. - Experience with assignment, MS-DRG/APR-DRG methodologies, and inpatient reimbursement guidelines preferred. - Certification as Certified Coding Specialist (CCS) required. - Preferred Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA). Requirements - Strong analytical and organizational skills. - Ability to prioritize workloads and meet deadlines. - Excellent customer service skills. - Ability to problem solve and work with minimal supervision. - Familiar with basic medical terminology. - Computer experience and typing ability. Benefits - Medical, Dental, and Vision Insurance. - Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year). - Paid Time Off. - Tuition Assistance Benefits. - Employee Referral Bonus Program. - Paid Holidays, Disability, and Life/AD&D for full-time employees. - Wellness Programs. - Employee Assistance Programs and more.

Role Description MediClaim Pros is seeking a detail oriented Medical Biller to manage the full lifecycle of insurance claims for our clients. This role is responsible for preparing, submitting, and following up on claims to ensure accurate and timely reimbursement. - Prepare and submit accurate medical claims to insurance companies using billing software and clearinghouses. - Review patient information, treatment documentation, and coding to ensure claim accuracy and completeness. - Monitor claim status and follow up with insurance payers to resolve unpaid or denied claims. - Perform denial management and resubmit corrected claims in a timely manner. - Post payments, adjustments, and reconcile accounts receivable balances. - Verify insurance eligibility and benefits prior to claim submission when required. - Maintain compliance with HIPAA and payer specific billing guidelines. - Communicate with internal teams to resolve discrepancies and improve billing workflows. Qualifications - High school diploma or equivalent required, associate degree in healthcare administration or related field preferred. - Minimum 2 years of experience in medical billing or revenue cycle management. - Familiarity with behavioral health or substance use disorder billing is preferred. - Knowledge of CPT, ICD coding basics and insurance claim processes. - Experience using electronic health records, billing software, and payer portals. - Proficiency with standard office tools including Microsoft Office and secure cloud based platforms. - Strong attention to detail and ability to manage multiple tasks efficiently. - Reliable high speed internet connection and dedicated workspace for remote work.

Role Description Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and/or CPT codes for billing, internal and external reporting, research, and regulatory compliance. Under the direction of the HIM Coding Manager, accurately codes conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting and/or CPT Assistant. Demonstrates knowledge of reimbursement methodologies and applies to assigned charts in order to optimize reimbursement and/or resolve regulatory edits. Resolve error reports associated with billing process, identify and report error patterns, and, when necessary, assist in design and implementation of workflow changes to reduce billing errors. Qualifications - Advance coding certification credential: - Certified Coding Specialist (CCS) - Certified Coding Specialist - Physician Based (CCS-P) - Certified Professional Coder (CPC) - Certified Professional Coder - Hospital Based (CPC-H) - Certified Medical Coder (CMC) - RHIT/RHIA certification - Radiology Certified Coder (RCC) - Certified Coding Associate (CCA) - Certified Outpatient Coding (COC) - Certified Inpatient Coder (CIC) - Certified Risk Adjustment Coder (CRC) - Certified Professional Coder-Payer (CPC-P) - Specialty coding certifications offered by AAPC (e.g., CASCC, CANPC, CCC, etc.) - Will consider RHIT eligible candidate who sits for the exam within one year of hire. - Full CPC certification must be obtained within 24 months if employee holds CPC-A from the American Academy of Professional Coders (AAPC) at time of hire or 36 months after certification if obtained after employment. - For HOMECARE: Homecare Diagnosis Coding Specialist (HCS-D) certification required within 16 months of hire. - Grandfather Clause: If hired on or before September 30, 2018, 2 years of relevant work experience and one of the following coding certification credentials are required: - Certified Coding Specialist (CCS) - Certified Coding Specialist - Physician Based (CCS-P) - Certified Professional Coder (CPC) - Certified Professional Coder - Hospital Based (CPC-H) - Certified Medical Coder (CMC) - Registered Health Information Technician (RHIT) - Registered Health Information Administrator (RHIA) - A specialty coding certification and Associate’s degree in Health Information Management. Requirements - Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), adheres to official coding guidelines and keeps abreast of coding changes and interpretation of codes. - Complies with RRH & HIM department policies & procedures. - Reviews appropriate provider documentation to identify & assign diagnoses & surgical procedure or treatment codes using ICD-10-CM and CPT procedure codes as defined in facility specific guidelines. - Meets established departmental productivity guidelines for the specific type of coding being performed with 95% accuracy on a consistent basis. - Utilizes Care Connect, UDS and Clintegrity systems proficiently to obtain ICD10-CM and CPT codes. - Utilizes technical coding principles and APC/E-APG reimbursement expertise to assign appropriate ICD-10-CM diagnoses and CPT procedure codes. - Formulates compliant coding queries when documentation is inadequate, ambiguous or unclear for coding purposes. - Enters and/or updates data accurately in various systems as departmental policy indicates. - Completes other duties as assigned by HIM leadership. - Provides assistance to customers (physicians, clinical quality staff) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process. - Assigns appropriate discharge disposition and/or modifiers based on established coding guidelines. - Analyzes clinical documentation to determine charge capture requirements for numerous clinical services. - Uses reports and application queues to identify targeted accounts on a daily basis. Works with CDM team to ensure appropriate charges are in place and that associated CPT codes are current. - Corrects failed claim errors to billing edits, accounts misclassified and/or other errors identified through various auditing processes in a timely manner. - Attends RGHS, HIM Department and Coding Team meetings and training sessions as required. - Ensures timely reporting for external regulations. Benefits - Pay Range: $20.75 - $29.50 - Eligible for additional pay components. - Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts. Company Description Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran.