Institute for Advanced Reconstruction, an ARSA Surgical Practice.
ARSA is a collective of Reconstructive Plastic Surgery Practices, providing the most advanced and cutting-edge reconstructive surgery in the United States. Specializing in Breast Reconstruction, microsurgical nerve repair, trauma surgery, craniofacial reconstructions, hand and upper extremity repair, ARSA practices have set the stage for the best tertiary care in the world.
ARSA has expanded its footprint to the Dallas market, with the Institute for Advanced Reconstruction complementing its other Texas-based practices. We are seeking a dynamic and experienced Healthcare Office Manager/Surgical Coordinator to join our team.
Job Description:
We are seeking a highly skilled revenue cycle professional to manage the full scope of our billing process in a busy surgical practice with 4+ practitioners. The ideal candidate will possess a strong understanding of medical billing and coding procedures, healthcare regulations, and insurance policies. They will be responsible for insurance verification, pre-authorization, accurately assigning diagnostic and procedural codes, submitting claims, and ensuring timely reimbursement from insurance companies.
Responsibilities:
- Review medical records and assign appropriate diagnostic and procedural codes using ICD-10-CM, CPT, and HCPCS Level II coding systems.
- Fully understand the scope of the practice’s payor contracts to assure billing accuracy and compliance with coding guidelines, regulatory requirements, and insurance policies.
- Verify patient insurance coverage, including eligibility and benefits related to specific procedures or treatments requiring prior authorization.
- Prepare and submit prior authorization requests to insurance companies, adhering to their specific guidelines and requirements, including completing necessary forms and providing supporting documentation to ensure maximum reimbursement.
- Monitor the status of prior authorization requests, follow up with insurance companies as needed, and track the progress of each case until a decision is reached.
- Contact patients to explain their benefits, answer questions and detail any patient financial responsibility.
- Contact patients and insurance companies to follow up on unpaid balances or medical claims.
- Review and analyze accounts receivable reports to identify overdue accounts. Update patient accounts with payment and billing information.
- Document all collection efforts and communications with patients and insurance companies.
- Provide excellent customer service to patients regarding their billing inquiries.
- Collaborate with healthcare providers and other staff members to resolve billing and coding issues.
- Maintain up-to-date knowledge of coding updates, reimbursement policies, and industry changes.
- Generate reports and analyze billing data to identify trends, discrepancies, and areas for improvement.
- Maintain confidentiality of patient information and adhere to HIPAA regulations.
Qualifications:
- High school diploma or equivalent required; associate or bachelor's degree preferred.
- Certification in medical coding (e.g., CPC, CCS) preferred.
- Minimum of 3-5 years of experience in medical billing and coding in a Surgical Practice.
- Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding systems.
- Strong understanding of medical terminology, anatomy, and physiology.
- Knowledge of insurance billing processes, including Medicare, Medicaid, and commercial payers.
- Excellent attention to detail and accuracy in coding and data entry.
- Effective communication skills, both verbal and written.
- A passion for customer service.
- Proficiency in using electronic health record (EHR) and billing software (e.g., Nextech preferred).
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
Experience:
- Medical coding: 3 years (Preferred)
Ability to Commute:
Ability to Relocate:
- Plano, TX: Relocate before starting work (Required)
Work Location: In person