Billing Specialist-MSH-78319-029

Review Medical charts and documentation within but not limited to the facility EMR, Epic, to ensure that all Physician charges are captured in a timely and complaint manner. Work with the Faculty Practice Group Compliance Manager and Administrator to ensue all FPG revenue is captured. 

Maintains a working knowledge of CPT and ICD-9/10CM coding principles, governmental regulations, protocols and third party requirements regarding coding and billing documentation.

Review and code patient encounters in EPIC with appropriate CPT, ICD-9CM, ICD-10CM and HCPCS codes for a multi-specialty group practice.  Services include inpatient, outpatient, Emergency, and ambulatory surgery for both E & M encounters and procedures. 

Utilizes the Correct Coding Initiative (CCI) edits for accurate assigning of code and make use of the Local Coverage Determinations for medical necessity.

Identify any areas for improvement in documentation as related to compliance and billing.  Query and/or meet with physicians regarding documentation and deficiencies.

Review edits, denials and requests for additional information from the accounts receivable team to ensure the time processing of claims and all revenue is captured. 

Maintains daily logs of coded work.

Assures that operative reports and other third party regulatory information are pertinent to coding requirements.

Works with management and the billing vendor daily, on edit list and/or requests for additional information as to reduce denials and accounts receivable. 

Attends various classes, seminars or trainings to keeping current with CPC certification. 

Reviews, modifies and recommends changes to policies and procedures to improve coding.

Performs other related duties as assigned.

Requires a level of understanding that is obtained or acquired through the completion of a High School Diploma.

Knowledge of Medical Terminology, ICD-9CM, ICD-10CM and CPT 4 coding certification obtained by completion of a certificate course with CPC / CCS-P credentials.

At least six months coding experience preferred. 

Certified Professional Coder/AAPC.

Ability to use computer. Average dexterity and knowledge of software applications such as Microsoft, Excel, etc.

Ability to work independently with minimal supervision at a high level of productivity.

Ability to examine scanned documents, such as operative reports to determine accuracy of coding.

Ability to prioritize own work and proceed with minimum supervision.

Ability to maintain strictest confidentiality according to HIPAA regulations.

Ability to work effectively with others as well as physicians.

Be able to perform effectively with various commercial and hospital computer applications.