You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a dedicated Medical Biller to join their team. The Coding & Charge Edits Specialist II will be responsible for reviewing and resolving coding-related prebilling edits and rejections, ensuring prompt and accurate reimbursement. The role involves initiating medical record reviews, processing charge corrections, and ensuring consistent charge capture processes and reimbursements.

Key Responsibilities

• Review and resolve coding discrepancies related to pre-billing system edits and claims with outstanding balances.
• Reduce accounts receivable by reviewing claims with outstanding balances.
• Research and respond to insurance coding requests.
• Assist with claim issues, including preparing coding appeals.
• Analyze and execute charge corrections to achieve account resolution.
• Research accounts and request necessary supporting documentation.
• Resolve all correction requests accurately and in a timely manner.
• Review and analyze denials and reach out to payers to settle accounts.
• Act as a point of escalation and monitor supervisory or secondary work queues.
• Perform edits on high dollar accounts.
• Assist Coding & Charge Edits Specialists I with questions and concerns related to coding and edits.

Qualifications

• High school graduate or GED certificate required.
• CPC Certificate required.
• Minimum of 1 year's experience in a physician billing or third-party payer environment.
• Working knowledge of contracts, insurance benefits, exclusions, billing requirements, claim forms, HMOs, PPOs, Medicare, Medicaid, and compliance program regulations.
• Ability to understand and navigate the payer adjudication process.
• Patient financial and practice management system experience in Epic or other electronic billing systems preferred.
• Knowledge of medical terminology preferred.
• Previous experience in an academic healthcare setting preferred.

Skills

• Billing experience.
• Experience with EPIC preferred.

Schedule

Monday-Friday, 8-4 or flexible hours.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

Medix is an equal opportunity employer and offers a supportive and inclusive work environment. All qualified applicants will receive consideration for employment without discrimination based on any protected characteristic.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.