The Center for Inherited Blood Disorders (CIBD) is a mission-driven non-profit focused on delivering high-quality, comprehensive, and family-centered care to improve the quality of life for children and adults with blood disorders. When choosing a career with CIBD, you will be part of a growing organization dedicated to improving public health and committed to your professional development.
Job Summary
Under the direct supervision of the Chief Financial Officer (CFO) and in close collaboration with the Senior Medical Biller and Coder, the Medical Biller & Coder processes the claims and coding for Clinic and Infusion Center services. Abiding by County, State and Federal regulations, the Medical Biller and Coder processes claims for every billable visit, codes the claims to the most appropriate level, sends the claims through the EMR for submission to the appropriate insurer, follows-up on the claims to ensure timely processing, works with the insurance companies for any denied claims, enters payments into the EMR and documents all billing related steps. The Medical Biller is familiar with industry standards and insurance companies, billing, and coding regulations. Additionally, the Medical Biller and Coder follows standards in accordance with the Centers for Medicare & Medicaid Services (CMS), California Children’s Services (CCS), Genetically Handicapped Persons Program (GHPP) and all other State and Federally sponsored programs.
Department: Administration Job Type: Permanent, Full-time Schedule: Monday - Friday (typically 8:30am-5:00pm) Location: Hybrid
Essential Job Duties
Code and process all billable visits using accurate E&M, CPT, ICD-10 and other billing codes and standards following timely filing guidelines, policies and procedures.
Work directly with the Triarq billing service to submit claims, timely review and follow-up on denied or delayed claims and post paid claims. Track all claim submissions through the Practice Management (PM) aspect of the Electronic Medical Record (EMR) system as well as any other tools agreed upon with the CFO.
Stay up to date on industry standards set by the Centers for Medicare & Medicaid (CMS), commercial insurance plans, Medi-Cal and county managed care plans by attending seminars, conferences and other programming related to claims and billing.
Prepare regular reports (weekly, monthly) on the status of claims and the financial impact of timely filing, lack of documentation and other things that can impact payment.
Participate in regular update meetings to ensure a keen understanding of the impact of billing on the overall success of CIBD.
Requirements
Completion of High School or equivalent.
Graduate from an accredited school or program in Medical Billing and Coding.
2 years experience in Outpatient Medical Billing.
1 year experience in Infusion, Pharmacy, or Lab Billing.
Experience working with all payers – commercial, government, Medicare, Medicaid.
Knowledge of CMS regulations and requirements regarding billing and coding.
Preferred Qualifications
Associates degree from an accredited college.
Certified Professional Biller (CPB) or Certified Billing and Coding Specialist (CBCS).
Billing and coding experience in an outpatient clinic setting.
Experience with infusion services billing and coding.
Experience with EMR/PM software.
Knowledge of CCS/GHPP/Medi-Cal regulations and requirements, and understanding of third party payer methods and regulations.
Knowledge of E&M, CPT & ICD-10 codes related to Hematology and related services.
Knowledge and understanding of the relationship between procedure and diagnosis compatibility to maximum reimbursement.
Knowledge of billing denials and appeals processes.
Licensure/Certification/Registration:
Basic Life Safety (BLS) training
HIPAA training
Benefits
100% employee coverage of medical and vision, and 99% employee coverage of dental
50% dependent coverage of medical and vision
FSA Health
Life insurance
Paid Time Off
10 observed paid holidays
403b retirement plan with 4% match
Compensation offered will be determined by factors such as location, level, job-related knowledge, skills, and experience.
About the Organization
The Center for Comprehensive Care & Diagnosis of Inherited Blood Disorders (CIBD), a 501(c)3 non-profit organization, is committed to providing comprehensive care for patients and their families with rare, chronic inherited blood disorders. CIBD is a part of a nationwide network of over 140 Hemophilia Treatment Centers that use multidisciplinary teams of blood disorder specialists to provide expert comprehensive diagnosis, medical care, outreach, education, outcomes monitoring, surveillance, and prevention services to people with hemophilia, Sickle-Cell Anemia, Thalassemia, Von Willebrand Disease, and other related hematology conditions. CIBD is the regional grantee for the Western States Region/Region IX providing regional leadership, fiscal and administrative oversight, grants management, capacity building, clinical education, technical assistance, evaluation, and outreach to public and private health agencies at the local, state, and federal levels.
The Center for Inherited Blood Disorders is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the company's non-discrimination policy.
We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.
www.cibd-ca.org
Flexible work from home options available.