Working under the supervision of the Central Billing Department Supervisors, the responsibilities include being accessible to physicians, staff, and patients regarding billing questions; ensuring that all billing functions are completed in a timely fashion and developing billing goals. Responsible for accurately coding provider’s outpatient and inpatient visits based on the documentation provided and abstracting accurate and complete patient care data to ensure optimum and timely reimbursement. Applies knowledge of specialized information specific to coding and medical terminology according to all coding guidelines.
Reports to: Revenue Cycle Supervisor
Manages: N/A
Education/Training:
* High school diploma or equivalent
Licenses/Certification:
• CPC or AHIMA coding certification
Required Qualifications and Skills:
* Minimum of 1-2 years of medical billing experience in either charge, payment or follow-up work
* Minimum of 1-2 years of coding experience for primary care, medical and surgical specialties or secured CPC, CCS-P coding certifications.
* Excellent written and oral communication skills with attention to detail
* Excellent interpersonal and organizational skills
* Competency with ICD-10 and CPT coding guidelines
* Ability to problem solve complicated claims
* Strong time management skills
* Able to multi-task various projects assigned
* Knowledge of anatomy, physiology, and pathology of disease processes and medical terminology
* Experienced in ICD-10 CM and CPT coding systems, guidelines and conventions, Coding Clinic, and CPT Assistant guidelines
Preferred Qualifications and Skills:
* Computer proficient
* Strong interpersonal communication skills
* Command of verbal and written English
* Flexible, highly motivated, capable of keeping abreast of constantly changing regulations, guidelines, insurance billing requirements, annual coding updates, and internal data needs
* Ability to interact with co-workers and physicians to resolve coding, documentation, and workflow issues
Essential Job Functions:
* Organize and code patient medical records for multispecialty providers into CPT and ICD10 codes.
* Acts as a liaison and overseer of the billing and claims process between insurers, medical offices, and patients.
* Prepare claims for invoicing to payers and patients.
* Correct rejected/denied payer claims and/or coding errors.
* Track and collect payments from third party payers.
* Work collaboratively with team members to resolve complicated claims.
* Communicate effectively with leadership regarding any delays in claims resolution that are at risk for timely filing.
* Handle confidential information and abide by all Sturdy Memorial Associate HIPAA laws and other billing office policies.
Other duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
AGE AND DIVERSITY RELATED CRITERIA: Consistently treats patients, colleagues, and visitors with dignity and respect while being sensitive to the differing needs of all age groups, backgrounds, characteristics, and cultures.
ABILITY TO FULFILL JOB EXPECTATIONS: Must have the ability to perform essential functions of the position, including required work hours, locations, and physical demands, without posing a direct threat to the health and safety of themselves or other individuals in the workplace, and with or without reasonable accommodation.
PHYSICAL DEMANDS: Physical demands refer to the level and duration of physical exertion generally required to perform critical tasks in support of critical job functions, for example - sitting, standing, walking, lifting, carrying, reaching, pushing, and pulling.
Sturdy Memorial Hospital is an equal employment opportunity employer. There is no discrimination because of race, color, creed, age, gender, sexual orientation, national origin, veteran status, or disability.
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