Billing/Coder Specialist – Union Office

Website NJRetina

NJ Retina is currently seeking an enthusiastic Medical Billing/Coder Specialist.

Billing/Coder Specialist Job Responsibilities:

The Billing/Coder Specialist is responsible for a variety of duties as assigned by the Director of Revenue Cycle. This includes but is not limited to surgical coding, billing payment posting, problem solving for all insurances and private payers.   The Billing Specialist is responsible for clear, detailed communication with all care centers, patients, and insurance companies regarding insurance and payment-related issues.  Maintain quality results by following NJ Retina standards.

Billing/Coder Specialist Job Duties:

  • Surgical Coding from operative reports
  • Interact with staff, patients, payers, billing system (Athena) and agencies to answer questions, obtain information and resolve issues
  • Review claim denials and make corrections to diagnoses, modifiers, procedures, or appeals with medical notes that includes all drugs through Athena
  • Monitor zero pay buckets to ensure claim is actually zero
  • Assist care centers with patient / insurance bucket issues
  • Work with Chronic Disease Fund (CDF), Commission for the Blind, correctional institutions, Pharmaceutical companies (for example, Lucentis / Eylea copay assistance program)
  • Responsible for unpostable / correspondence dashboard
  • Accountable for patient buckets and working on collection report on a monthly basis; forwarding balances to the collection agency
  • Mail (EOB’s bankruptcy letters, undeliverable mail, letters for patients)
  • Answer telephone calls for the Central Business Office to assist patients with their bills, insurances or refunds
  • Participate in and assist with audits as needed
  • Work offsets, overpayments and refunds
  • Work the workflow dashboard on a daily basis
  • Attend and participate in NJ Retina and payer meetings / seminars as needed
  • Monitor aging reports and take necessary steps to guarantee payment of claims
  • Other duties and projects as assigned
  • Maintain open, positive, cordial, team-oriented lines of communications with Management and staff members
  • Contribute to the Central Business Office team through positive attitude, respectful interaction, innovative ideas and efficiency

Billing/Coder Specialist Skills and Qualifications:

  • Certified Professional Coder certification (CPC)-AAPC.
  • Ability to work independently and to work collaboratively on projects
  • Ability to interface with management and co-workers
  • Ability to create channels of communication to obtain information necessary to perform job tasks, such as with clients, payers, clinical staff and billing department staff
  • Ability to recognize individual and system problems and to communicate such information to the supervisor
  • Excellent written and verbal communication skills
  • Outstanding attention to detail and excellent time management skills *This position requires mastery of a large amount of detail
  • Outstanding computer skills with billing software, Microsoft Word and Microsoft Excel, able to learn our system, good typing skills
  • Experience with Medicare, insurances, claims, appeals
  • Maintain confidentiality at all times


NJRetina is an Equal Opportunity Employer

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