Medical Billing and Coding Specialist (Administrative Specialist II), Grade N21
Montgomery CountyAbout the Position
“Please note: The salary range above represents this position’s earning potential. The anticipated hiring range for this position will be $70,556 to $103,360, based on the candidate’s qualifications and experience.”
Medical Billing and Coding SpecialistWHO WE ARE
Montgomery County is located adjacent to Washington, D.C., and with over one million residents, is the most populous County in the State of Maryland. The County is also the most diverse County in the State and ranks among the top ten most diverse Counties in the nation. Montgomery County contains many major U.S. government offices, scientific research and learning centers, and business campuses.
The Department of Health and Human Services is responsible for delivery of the County’s public health and human services that meets the needs of our community’s most vulnerable children, adults and seniors. The Department provides services through more than 120 programs at more than 20 locations. With over 2,000 employees, the Department of Health and Human Services is the largest County Department.
As a department, we believe the health and wellness of the county can only be achieved by ensuring that every resident has fair opportunities to reach their fullest potential. This means access to quality housing, transportation, education, employment, health care, human services, safe neighborhoods, and healthy food. HHS provides critical services for residents who face a variety of obstacles in achieving their full potential. HHS plays an essential role in building a healthy and strong community.
WHO WE ARE LOOKING FOR
The Chief Operating Officer Division is currently recruiting for a medical credential, Biller and Coder to join our dedicated team supporting the Department of Health and Human Services (DHHS). With a mission to serve 300+ billing providers, this is an exciting opportunity for a skilled and detail-oriented professional to play a vital role in ensuring accurate billing and coding processes that directly impact the success of our programs and services. We are looking for someone who is passionate about making a difference, thrives in a collaborative environment, and is committed to excellence in their work. If you’re ready to contribute your expertise to a mission-driven organization, we encourage you to apply!
What You'll Be Doing
As the Medical Billing and Coding Specialist, you will have responsibilities for both billing and coding.
Billing: This duty involves ensuring that all procedures and services provided to patients are properly coded and billed to insurance companies, government programs, and patients. Specific responsibilities include:
- Review medical records and physician documentation to ensure accurate coding of procedures and services.
- Assign appropriate codes to medical procedures and services using various coding systems, such as ICD-10, CPT, and HCPCS.
- Verify patient insurance coverage and obtain necessary authorization for procedures and services.
- Prepare and submit insurance claims to appropriate payers, including government programs such as Medicare and Medicaid.
- Follow up on unpaid or denied claims and resolve any billing discrepancies or errors.
- Communicate with patients, insurance companies, and healthcare providers to resolve billing issues and answer questions about insurance coverage and payments.
- Maintain patient billing records and update patient information in billing systems.
- Ensure compliance with government regulations and insurance requirements, including HIPAA regulations and Medicare billing rules.
- Participate in training and continuing education programs to stay up to date on changes in medical coding and billing practices.
- Work collaboratively with other healthcare professionals, such as physicians, nurses, and administrative staff, to ensure effective billing and coding processes.
Coding: This duty involves assigning appropriate codes to medical procedures, diagnoses, and treatments using standardized coding systems such as ICD-10 and CPT. Accurate coding is essential for appropriate billing, reimbursement, and regulatory compliance. Specific responsibilities include:
- Supporting tasks for the coding duty may include:
- Reviewing medical records and patient charts to ensure accuracy and completeness
- Assigning appropriate codes to medical procedures, diagnoses, and treatments using standardized coding systems
- Keeping up to date with changes to coding standards and regulations
- Training and educating other staff members on coding processes
- Credentialing: This duty involves verifying and maintaining the qualifications of healthcare providers, ensuring that all healthcare providers have the appropriate licenses, certifications, and credentials to practice in their respective fields. Proper credentialing is essential for patient safety and regulatory compliance.
- Supporting tasks for the credentialing duty may include:
- Verifying healthcare provider licenses, certifications, and credentials
- Maintaining accurate and up-to-date records of healthcare provider qualifications
- Ensuring compliance with regulatory requirements related to healthcare provider qualifications
- Providing training and education on credentialing processes
- Performing other job-related duties as assigned.
Some off-site work may also be required.
A background investigation will be conducted into the selected candidate prior to appointment and will be a significant factor in the hiring decision.
Minimum Qualifications
Education: Graduation from an accredited college or university with a Bachelor's Degree.
Experience: Two (2) years of professional administrative experience related to medical and coding billing practices, including knowledge of CPT, HCPCS, and ICD-10 Codes.
Substitutions:
1. EDUCATION for EXPERIENCE: Additional education will substitute for the required experience on a year-for-year basis.
2. EXPERIENCE for EDUCATION: Additional administrative, business, research, and/or clerical experience will substitute for the required education on a year-for-year basis.
Candidates with a license or certification in medical billing and coding are strongly preferred.Preferred Criteria, Interview Preferences
Preferred Criteria:
The applications of those individuals meeting the minimum qualifications will be reviewed to determine the extent, relevance of training, and experience in the following areas:
- Knowledge of healthcare compliance
- Experience in revenue cycle management
- Experience with credentialing and privileging
- Experience with data analysis and problem-solving
- Experience writing reports
- Knowledge of HIPPA regulations
Interview selection will be based on the following interview preference criteria:- Demonstrating oral and written communication skills.
- Ability to work effectively with internal and external stakeholders, including providers, payers, and patients.
- Experience with credentialing and privileging process for healthcare providers, including knowledge of Joint Commission and other accreditation standards.
- Demonstrating strong analytical and problem-solving skills, identify trends and develop strategies to improve revenue cycle performance
IMPORTANT INFORMATION
The Office of Human Resources (OHR) reviews the minimum qualifications of all applicants, irrespective of whether the candidate has previously been found to have met the minimum requirements for the job or been temporarily promoted to the same position. This evaluation is based solely on the information contained in the application/resume submitted for this specific position.
Montgomery County Government(MCG) is an equal opportunity employer, committed to workforce diversity. Accordingly, as it relates to employment opportunities, the County will provide reasonable accommodations to applicants with disabilities, in accordance with the law. Applicants requiring reasonable accommodation for any part of the application and hiring process should email OHR at Hiring@montgomerycountymd.gov. Individual determinations on requests for reasonable accommodation will be made in accordance with all applicable laws.
MCG also provides hiring preference to certain categories of veterans and veterans/persons with a disability. For more information and to claim employment preference, refer to the Careers webpage on Hiring Preference.
All applicants will respond to a series of questions related to their education, relevant experience, knowledge, skills, and abilities required to minimally perform the job. The applicant's responses in conjunction with their resume and all other information provided in the employment application process will be evaluated to determine the minimum qualifications and preferred criteria or interview preference status. Based on the results, the highest qualified applicants will be placed on an Eligible List and may be considered for an interview. Employees meeting minimum qualifications who are the same grade will be placed on the Eligible List as a "Lateral Transfer" candidate and may be considered for an interview.
This will establish an Eligible List that may be used to fill both current and future vacancies.
If selected for consideration for this position, you may be required to provide evidence that you possess the knowledge, skills, and abilities indicated on your resume.
Montgomery County Ethics Law: Except as provided by law or regulation, the County's "Public Employees" (which does not include employees of the Sheriff's office) are subject to the County's ethics law including the requirements to obtain advanced approval of any outside employment and the prohibitions on certain outside employment. The outside employment requirements of the ethics law can be found at 19A-12 of the County Code. Additional information about outside employment can be obtained from the Ethics Commission website.