Job Abstract

SCOPE OF POSITION: Codes and enters office and hospital charges, visits and procedures, performs audits, maintains reports, investigates coding and billing issues, initiates appeals, takes corrective actions, ensures compliance with federal and commercial coding and billing guidelines.

RESPONSIBILITIES:

• Codes and enters Office and Hospital E&M, Non Interventional and Interventional procedures, and professional services performed.
• Reviews and corrects billing records with inconsistent information and/or containing discrepancies. Informs physicians and staff of corrections made.
• Assists with audit requests from government and commercial insurances.
• Works with practice EMR as well as third party software in managing hospital services
• Reviews coding denials/edits and appeals/corrects billed charges.
• Prepares reports/data as requested for productivity, audits, or as requested for practice, hospital or parent company.
• Contact physicians and other health care professionals with questions about treatments or diagnostic tests given to patients with regard to coding procedures.
• Reviews medical records to validate that the appropriate codes were captured and documented in medical records.
• Submit statistical data for analysis and research by other departments.
• Responds to coding and billing questions from physicians and staff.
• Works closely with direct manager and billing team to meet the operational needs of the organization.
• Informs management of issues or concerns identified with coding and billing practices.
• Provides feedback and education to physician and clinical staff regarding changes in coding as identified.
• Answers questions to patients, providers, and staff regarding services billed.
• Attends meetings and travels to other affiliate locations as necessary.
• Performs other duties as assigned or required.

REQUIREMENTS:

• High school diploma
• Must have coding certification, CPC; certification must be current
• Must maintain continuing education to maintain CPC certification.
• 3 years' experience in medical coding, preferably in Urology
• Prior Experience in physician billing including ICD-10, CPT medical billing, and EMR charting.
• Must be able to work independently and as part of a team.
• Electronic Medical Record, Practice Billing Experience
• Excellent written and oral communication
• Must have attention to detail