Full Cycle Biller (Charge Entry Coding/Auditing)

JOB TITLE: Full Cycle Biller, Charge Entry Coding/Auditing

FLSA STATUS (Exempt/Non-Exempt): Non-Exempt

SUPERVISION RECEIVED: Reports to Billing Manager

SUPERVISION EXERCISED: NONE

GENERAL STATEMENT OF DUTIES

Full Cycle Biller, Charge Entry Coding/Auditing supports the billing department by assisting with managing incoming and outgoing charges and payer responses while verifying and ensuring accuracy and completeness for a complete billing cycle.

ESSENTIAL FUNCTIONS

• Utilizes ICD.10, CPT, & HCPCS coding principles to review provider charges for accurate documentation and submission of billing.
• Utilizes knowledge of CPT, HCPCS & ICD.10 coding to assist in onboarding new services.
• Utilizes knowledge of payer medical and billing policy guidelines for coverage to ensure correct billing and coding for proper payment and reduction of claim errors and denials.
• Assists with receivables account review and reconciliation for claim rejections and denials.
• Speaks to patients as needed in a timely and professional manner.
• Identifies and reports issues or errors, such as incomplete or missing records and documentation, ambiguous or non‑specific documentation, or codes that do not conform to approved coding guidelines while utilizing professional communication and documentation skills.
• Demonstrates the ability to self‑report daily tasks and assignments as well as identify any billing trends that affect daily productivity.
• Other duties as assigned.

EDUCATION

• High School Diploma / GED Certification

EXPERIENCE

• Two years of experience in lieu of education considered
• Next Gen Office (NGO) and Advanced MD experience preferred
• Experience in Pain Management, Orthopedic surgery, Vascular and/or Anesthesia preferred

KNOWLEDGE

• Knowledge of CPT, HCPCS, ICD.10 and the ability to follow coding guidelines.
• Knowledge of Medical Terminology
• Billing Experience or Medical Office Experience
• Strong office and computer skills, experience with paperless workflows
• Prior use of practice management and EMR programs
• Basic understanding of Microsoft Office to include Outlook, Teams, MS Word, and Excel.
• Understanding of insurance benefits, adjustments, reviews, authorizations.

SKILLS

• Displays strong ability to prioritize, multi‑task
• Skilled communicator and ability to work effectively in resolving problems
• Solid organizational skills
• Exceptional attention to detail.
• Work independently while maintaining a positive attitude

ABILITIES

• Ability to understand insurance payer guidelines.
• Ability to prioritize and solve problems in a timely manner.
• Ability to communicate effectively and professionally with insurance carriers and outside entities.
• Ability to interact with management, physicians, and teammates at all levels and effectively.
• Ability to communicate with teammates and management both in oral and written form.
• Ability to meet deadlines in a fast‑paced, quickly changing environment.
• Ability to act as gatekeeper and elevate relevant information to management as needed.
• Ability to treat confidential information with appropriate discretion.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.