Emergency Medicine Billing Specialist

Explore and excel. At Banner Health, health care is a team effort.  One might be surprised by the number of people who work behind the scenes and play a critical role in ensuring the best care for our patients. 

Our Emergency Medicine Revenue Cycle Team is looking for a Emergency Medicine Revenue Cycle Specialist. Our department is a small knit team.  We work well together in a fast-paced environment. The technologies being used are MS4, NextGen, RCx, Cerner. Our department offers a sense of reward when getting the job done, knowing we are getting the bills out the door correctly.  Being a small team, we are able be accountable and offer flexibility.

Bring your years of Insurance and Physician Billing knowledge to this Emergency Department Physician Billing and have endless opportunities to grow in a career path at Banner Health! A Certified Medical Coder with Medical Coding & Billing knowledge is a plus! This person will cross train with a coder to understand all aspects. Anyone that will actually be doing coding must be certified. We are looking for someone who is highly motivated and able to stay on task. Production expectations are releasing 200 visits a day for billing. This is a relaxed environment and supportive team, and working together in our small knit group brings a sense of accomplishment when we work together toward the end goal. You will be fully supported in training with continued support throughout your career here.

POSITION SUMMARY
This position leads in development, analysis, preparation, and implementation of strategic and operational plans to optimize effectiveness of Department of Emergency Medicine/BUMG revenue cycle systems and operational performance. The position provides analytical support for revenue cycle operational goals which includes analyzing processes and identifying opportunities for improvements in operational practices and procedures. Designs, implements, and supports adoption of processes to increase efficiency and compliance while maximizing highest level of quality.

CORE FUNCTIONS
1. Analyzes, designs, and implements efficient system of processing emergency department Point of Care Ultrasound (POCUS) coding and billing for both facility and professional services. Manages on-going quality assurance efforts to ensure accuracy and compliance with coding and billing best practices and standards. Serves as liaison between emergency department and the College of Medicine leadership.

2. Serves as a subject matter expert in emergency medicine coding and billing. Reviews the daily coding hold list returned by specialty third party coders, takes action to resolve, clarify and correct complex billing issues or anomalies to support timely reimbursement deadlines. Resolves billing issues such as duplicate charges, missing charges unbillable charts.

3. Acts as a liaison between providers and specialty third party coding group leadership regarding all issues of coding work flow including reconciling visits seen versus charged, documentation requirements and any items requiring resolution to support timely processing.

4. Develops and implements a system to on-board and conduct regular educational sessions with all emergency department providers regarding compliant documentation and coding. This includes Faculty Attending Physicians, Fellows, NP’s, and Residents.

5. Acts as a revenue cycle operational consultant with expertise in emergency medicine documentation and coding to continually educate and give feedback to Faculty Physicians regarding effective practices to capture RVU’s for services rendered. Identifies and works with outlier physicians to improve their RVU capture

6. Produces regular reports with analysis of coding queues and reconciliation of visits seen versus billed and follow up with all providers regarding incomplete charts or charts completed but not sent for coding and billing.

7. Acts as a knowledge resource to clinical staff for billing code issues.

8. Works independently under general supervision and utilizes analytical and creative thinking skills, and influencing abilities. Training responsibilities include Faculty Attending Physicians, Physician Residents, as well as other Providers. Customers include external coding agencies, Health Information Management, Financial Services and Clinical Documentation leadership and staff, as well as other members of the integrated healthcare team.

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a related health care field.

Must demonstrate an elevated level of knowledge and understanding of ICD10 and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as required for the assigned practice areas. Requires three or more years of specialized professional coding experience for clinical specialty areas. Must be able to achieve an acceptable accuracy rate on the coding test administered by the hiring business unit according to pre-established company standards. Requires the ability to work autonomously while maintaining a high level of accountability and quality performance outcomes. Must demonstrate excellent critical thinking and organization skills. Requires attention to detail.

Must be able to work effectively with common office software, coding software, and abstracting systems.

PREFERRED QUALIFICATIONS

EEO/Disabled/Veterans

Our organization supports a drug-free work environment.

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