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Summary:Reviews, analyzes, and coordinates charge master activities for the department. reviews, analyzes and coordinates ICD coding activities for the department.Detailed responsibilities:Utilizes clinical and coding knowledge to ensure accurate and compliant charge items and to recognize and resolve billing inconsistencies.
Utilizes clinical and ICD coding knowledge to ensure accurate and compliant diagnoses and to recognize and resolve diagnostic coding inconsistencies.
Conducts compliance research. Develops and maintains a compliance resource library.
Coordinates audits to improve processes related to revenue cycle, efficiency of charging and billing, and collection efforts.
Analyzes content of system-generated reports and software edits to facilitate revisions with appropriate clinical departments.
works with management and intradepartmental employees to improve and optimize billing and coding practices.
Competencies and skills:Essential:STANDARDS OF BEHAVIOR: Acts in a manner that supports the standards of communication, respect, privacy, and teamwork by demonstrating a commitment to professional and ethical conduct.
CUSTOMER SERVICE: Demonstrates commitment to service excellence by promptly addressing internal/external customer issues/requests, resolving concerns while maintaining a professional image and behavior to build and enhance the patient/family/customer experience.
ACCOUNTABILITY: Accepts ownership of job roles and specific assignments/goals; works independently, takes responsibility for own actions; admits mistakes and judgment errors; and accepts constructive feedback. Connects personal work results to the accomplishment of team and organizational goals.
RESPONDING TO CHANGE: Accepts change and adapts in a positive and productive manner; handles unexpected situations and changes in direction calmly and with confidence. Views new assignments and job responsibilities as an opportunity for growth.
ACCOUNTS RECEIVABLE FOLLOW-UP: Resolves denials of payment and incorrect payments from insurance carriers.
BILLING: Processes accurate payor claims to ensure timely reimbursement.
ACCURACY: Completes work assignments within established quality and/or quantity standards.
EFFECTIVE COMMUNICATION: Communicates effectively with various audiences using the most appropriate method for the situation.
ORGANIZATION SKILLS: Organizes work to achieve maximum efficiency.
PATIENT AND FAMILY CENTERED CARE: "Provides Patient and Family Centered Care to patients, families, visitors and internal customers"
Education:Essential:High School Diploma or Equivalent
Credentials:Essential:Coding Certification
Other information:Complexity of Work: Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.Required Work Experience: 2 years experience with progressive CPT and ICD coding experience with outpatient coding. Two years experience in medical billing.CPC (Certified Professional Coder) or a Certified Coding Associate (CCA) with completion of a Certified Coding Specialist (CCS) within second year of employmentWorking conditions:Essential:Keyboard Entry 80.00%
Reaching 40.00%
Repetitive Movement Hand/Arm 80.00%
Sitting 80.00%
Standing 60.00%
Walking 60.00%
Audible Speech 80.00%
Hearing Acuity 80.00%
Depth Perception 80.00%
Distinguish Color 80.00%
Seeing - Far 80.00%
Seeing - Near 80.00%
Dust 60.00%
Computer Monitor 80.00%
Wet or Slippery Surfaces 40.00%
Organizational Profile:Memorial Healthcare System, consisting of 6 acute care hospitals, a nursing home, outpatient facilities, home health services and physician practices, provides quality, comprehensive care to the residents of the surrounding communities. We invite you to join one of the nation's leading healthcare systems, recognized for use of advanced technology and clinical informatics.Memorial Support Services provides a variety of business services to support our facilities. The main offices are located in Miramar with satellite offices located throughout our system.Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.
Full-time