Human Resources

Title: Medical Coder and Biller
Classification: C2
Department: Kirkhof College of Nursing

Job Summary:
Based on information from client visit, coding of visit and services performed and submits bill to appropriate source - insurance or individual client. Maintains knowledge and skills in this rapidly developing area of health information.

Primary Duties & Global Responsibilities:

  • Ensures that all client data is properly entered into billing system
  • Verifies coding of visit based on documented services provided
    Analyzes information and compares with HCFA guidelines for ICD-9 and CPT Medical Coding
  • Collaborates with care provider to adjust coding, based on analysis
  • Formats billing according to software system and insurer's specifications
  • Submits bills either electronically or manually, according to insurer's guidelines
  • Ensures that bills are submitted in a timely manner (depends on each insurer's guidelines)
  • Prepares and submits statements to patients
  • Enters receipt information when payment received
  • Follow up on collections
  • Handles clients questions and/or concerns related to billing in a timely and courteous manner
  • Communicates courteously, confidently with health care providers, their office staff and clients
  • Maintains confidentiality of client records
  • Collaborates as member of the health care team, developing goals and strategies for health centers to continuously improve the quality of service delivery
  • Participates in annual self, peer and supervisor evaluation
  • Meets established goals annually
  • Seeks and takes opportunities to improve own knowledge and skills for personal and professional growth

Minimum Required Qualifications:

  • High school graduate.
  • Completion of education program focused on medical coding and billing and one year of experience or two years experience doing medical billing and coding in health provider office environment
  • Ability to utilize computer and billing software
  • Ability to use excellent grammar and proofreading skills
  • Ability to maintain satisfactory work performance and attendance record
  • Ability to work confidently, under pressure and meet deadlines
  • Possess strong verbal and written communication skills
  • Ability to maintain positive interpersonal relationships

Accidents or Health Hazards:
Requires exposure to communicable diseases and/or body fluids, toxic substances, medicinal preparations and other conditions common to a health care clinic environment.

Supervision Received: (Who provides supervision?)
Receives supervision and work assignments from Nurse Practitioner and/or Director, although other staff in health center may provide work direction

Supervision Exercised: (Whom do you supervise?)
Collaborates with data manager for generation of reports as needed. May supervise student employees as needed.

Revised Date: September 1997 For questions regarding employment, email Human Resources Employment Information. TDD Callers: Call Michigan Relay Center 1-800-649-3777.