RieLes Group is seeking a Senior Level Medical Billing and Coding Expert to provide services for the Armed Forces Retirement Home (AFRH) in Washington, DC. Resident population includes Long Term Care, Memory Support, Assisted Living, Independent Living Plus, and Independent Living. Approximately 80 percent of AFRH residents are covered by Tricare, and 95 percent of them are covered by Medicare Part D and Supplemental insurance/other health insurance.

Duties:

• Coding: Assigning medical codes to diagnoses and procedures, and ensuring they meet coding guidelines and insurance standards
• Billing: Ensuring the accuracy and timeliness of billing submissions, and resolving billing discrepancies
• Analyzing records: Reviewing medical charts, doctor's notes, and other patient information
• Collaborating: Working with healthcare providers and insurance companies to streamline billing processes
• Improving: Continually improving coding standards and understanding the causes of claim denials
• Auditing: Assisting in internal or external audits by providing coding documentation or clarifications
• Adhering to regulations: Ensuring compliance with industry standards and regulatory requirements
• Communicating: Advising contract company and providers on billing and documentation policies and procedures

Qualifications:

• A minimum of 5 years of experience as a Senior Level Billing and Coding Specialist
• Experience billing Tricare, Medicare Part D and Supplemental insurance Providers.
• Certification from an accredited certifying body: CPC/COC/CCS from AAPC or AHIMA
• Understanding of the US healthcare industry, client-specific processes, and regulatory requirements
• Familiarity with medical terminology, anatomy, physiology, diagnosis, and procedural terminology
• Excellent references
• All Contractor employees are required to undergo background security investigations to ensure suitability for employment with a federal entity