firsthand

Billing Specialist

• Become subject matter expert in the capabilities of firsthand's billing systems, including EHR and Clearinghouses
• Appropriately codes services, procedures, diagnoses, and treatments. Verifies that the assignment of International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedural Coding (HCPC) codes are compatible, appropriate, and accurate for billing
• Use medical terminology to understand clinical documentation and determine if it appropriately supports diagnoses. Reviews all individual visit encounters for completeness and accuracy in all services rendered
• Educates firsthand Advance Practice Nurses (APNs), Nurse Practitioners (NPs), and other team members on proper code selection, documentation, procedures, and requirements. Provides technical guidance to APNs, NPs, and other team members in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines
• Prepares and submits claims for payment, and corrects rejected claims
• Advises on ongoing process improvements related to coding and billing. Makes recommendations for changes in policies and procedures, e.g., revising the master CPT list. Develops and updates procedures manuals to maintain standards for correct coding, and to minimize the risk of fraud and abuse

Coding and Billing Specialist