Grace Health · 4 months ago
Billing and Coding Support
Corbin, KY
Full-time
Onsite
Entry, Mid Level
2+ years expGrace Health is a faith-based, federally qualified community health center providing primary health services to underserved individuals in southeastern Kentucky. They are seeking a Billing and Coding Support professional responsible for reviewing provider charges, processing claims, and ensuring timely submission of charges while providing support to the billing company.
Health CareHospitalMedicalPrimary and Urgent Care
Responsibilities
Understand functions within the Practice Management system of Nextgen including batch posting, holding tank, charge screen, and work log
Collect hospital charges from Women’s Care providers on a routine basis in addition to reviewing weekly hospital surgery schedules and daily census in order to ensure timely submission of charges. Download all pertinent information including Patient H&P, Face Sheet, and Discharge info from the hospital’s EMR system, review documentation and using most recent Coding Books assign CPT codes, ICD-10 codes, and modifiers. Enter charges into Nextgen system when the required documentation is available and the patient has been discharged. Utilize provider as a resource for any questions
Maintain monthly lists of NSTs, Surgeries, and Deliveries
Coordinate signed consents for Tubal and Hysterectomies with surgery scheduling staff at Women’s Care office
Reconcile hospital charges monthly; f/u as required
Follow Up on encounters related to Hospital Services placed in the Work Log
Collect Nursing Home and Home Visit charges from the Providers; f/u with Providers when the template has not been completed for billing. Look up the ICD-10 diagnosis, manually enter charges in Nextgen, check insurance eligibility and pull over correct insurance(s); process charges, ensure claim has dropped with the correct Revenue Code and MC G Pmt. code; follow up on NH or Home Visit encounters in the Work Log
Review and Process Dental Charges from the Holding Tank; ensure Dental Hygienist Visits are auto adjusted. Work with each Dentist office to reconcile invoices and then send to the Dir. of Finance for processing. Regularly work the Denial Report and alert leadership of Credentialing, KY Wrap, Timeliness or any other trends that need addressed. Follow up on Dental encounters sent in the Work Log
Review and Process Medical, Behavioral Health, and Telehealth charges from the Holding Tank. Review Insurance, Location, and Provider related information. Review ICD-10 and CPT codes. Add appropriate modifiers, global codes, zero out charges as indicated in Standard Operating Procedure, change Place of Service when needed, and process Sliding Fee out of the charge screen and calculate and calculate/apply Prompt Pay Discounts
Credentialing hasn’t been completed or ancillary charges have been submitted but E/M or Preventive CPT have not. Task providers when questions arise during claim processing
Work Log follow up for claim prod errors, medical records and authorization requests, coding errors, credentialing issues etc. Trends should be identified and shared with appropriate leadership so pertinent information can be shared or changes can be made to reduce future denials
Process Un-Applied Credits
Verify Patient Credits and collaborate with Accounts Payable to process
Appropriate referral/coordination with staff who can make adjustments
Help answer Customer billing questions as needed and refer questions to Leadership
Follows policies and procedures of the office, including administrative, clinical, quality assurance, and personnel
Maintain good attendance (daily, meetings, and other assignment tasks)
Maintain timely documentation of all work assignments
Maintain patient confidentiality
Routinely keep supervisor informed about attendance and job assignments
Flexible in being able to multitask
Work effectively and at an efficient pace
Work cooperatively with physicians, administration, and peers
Team members must demonstrate excellent team communication and coordination to provide quality patient care
Care coordination includes communicating with community organizations, health plans, facilities, and specialists
Care team members understand and embrace the concept of population management and proactively address the needs of patients and families served by this practice
Team members must demonstrate skill and knowledge related to effective communication with vulnerable patient populations
Team members will participate in Continuous Quality Improvement activities within the organization to ensure patients receive high quality care
All team members will be involved in the process of improving quality incomes
Team members will participate in the review and evaluation processes of practice performance and help to identify opportunities for improvement
Qualification
Required
Must have completed high school
Must have a minimum of 2 years medical office billing experience
Understand functions within the Practice Management system of Nextgen including batch posting, holding tank, charge screen, and work log
Collect hospital charges from Women's Care providers on a routine basis in addition to reviewing weekly hospital surgery schedules and daily census in order to ensure timely submission of charges
Download all pertinent information including Patient H&P, Face Sheet, and Discharge info from the hospital's EMR system, review documentation and using most recent Coding Books assign CPT codes, ICD-10 codes, and modifiers
Enter charges into Nextgen system when the required documentation is available and the patient has been discharged
Utilize provider as a resource for any questions
Maintain monthly lists of NSTs, Surgeries, and Deliveries
Coordinate signed consents for Tubal and Hysterectomies with surgery scheduling staff at Women's Care office
Reconcile hospital charges monthly; f/u as required
Follow Up on encounters related to Hospital Services placed in the Work Log
Collect Nursing Home and Home Visit charges from the Providers; f/u with Providers when the template has not been completed for billing
Look up the ICD-10 diagnosis, manually enter charges in Nextgen, check insurance eligibility and pull over correct insurance(s); process charges, ensure claim has dropped with the correct Revenue Code and MC G Pmt. code; follow up on NH or Home Visit encounters in the Work Log
Review and Process Dental Charges from the Holding Tank; ensure Dental Hygienist Visits are auto adjusted
Work with each Dentist office to reconcile invoices and then send to the Dir. of Finance for processing
Regularly work the Denial Report and alert leadership of Credentialing, KY Wrap, Timeliness or any other trends that need addressed
Follow up on Dental encounters sent in the Work Log
Review and Process Medical, Behavioral Health, and Telehealth charges from the Holding Tank
Review Insurance, Location, and Provider related information
Review ICD-10 and CPT codes
Add appropriate modifiers, global codes, zero out charges as indicated in Standard Operating Procedure, change Place of Service when needed, and process Sliding Fee out of the charge screen and calculate and apply Prompt Pay Discounts
Hold processing as needed
Pleasant personality and professional demeanor
Cooperative attitude-Flexible
Detail Oriented
Effective written and oral communication skills
Highly organized work habits with ability to prioritize
Intermediate computer skills with Microsoft Word and Excel
Familiar with Electronic Medical Record
Preferred
Medical Office experiences a plus
Benefits
Safe harbor 401(k) with match potential
Paid time off
Family friendly work environment
Health insurance
Wellness program
Health savings account
Pharmacy benefit
Employee visits for medical services
Dental insurance
Vision insurance
Life Insurance
STD/LTD
EAP & Work life services
Voluntary benefits
Company
Grace Health
Grace Health provides pediatric and primary care to patients with outreach, education, and behavioral health services.
201-500 employees
H1B Sponsorship
Grace Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
2024 (1)
2023 (3)
2022 (1)
2021 (2)
Funding
Current Stage
Growth StageTotal Funding
$0.2MKey Investors
Kentucky Opioid Abatement Advisory Commission
2023-10-02Grant· $0.2M
Leadership Team
Michael Stanley
CEO
Company data provided by crunchbase