Job summary
Performs accurate and timely billing, coding, and reconciliation of moderately complex accounts.Serves as a resource to others for coding and charging questions.Assists with training and special revenue projects under the Supervisor's guidance.
Job seniority: mid-to-senior level
Responsibilities
• Independently performs coding of complex accounts, to include interventional cardiac catheterization lab and/or interventional radiology procedures, and diagnostic radiology tests.• Translates narrative information from billing encounter forms and orders into ICD-10 and CPT-4 codes.• Independently performs charging, coding, and reconciliation of complex accounts, to include interventional cardiac catheterization lab and/or interventional radiology procedures.• Identifies billing errors or missing revenue or charges based on raw data.• Monitors revenue reports and patient schedules daily.• Investigates and resolves issues to ensure charges and billing codes are entered in a timely manner.• Assesses and identifies non-routine barriers to posting revenue and refers to proper authority.• Independently uses electronic medical records and multiple systems to identify diagnosis codes, procedure codes, and medical supply charges for most services, including interventional cath lab or IR.• Identifies and resolves charging discrepancies previously generated by referencing medical record.• Performs ICD-10-CM diagnostic and CPT-4 coding at a minimum accuracy rate of 95%.• Researches and resolves billing, coding, charging, and medical necessity edits for diagnostic and most interventional services with a high level of accuracy.• Researches and resolves discrepancy so charges keyed reflects services delivered.• Serves as back-up to other billers and some supervisor's responsibilities.• Understands different billing systems, charge codes, and billing regulations.• Researches and identifies action needed to post revenue for area not usually assigned.• Provides billing and coding consultation for departments without revenue staff, such as the ED and Pulmonary medicine.• Works with clinical department directors to ensure smooth revenue workflows.• Identifies department-based barriers to timely revenue posting, such as workflow process steps and personnel.• Under direction of supervisor, participates in department performance improvement projects for revenue operations.• Identifies process and policy changes to ensure revenue is posted daily.• Attends and participates in required hospital education programs to maintain and enhance their coding skills and stay abreast of changes in codes, coding guidelines, and regulations.• Performs chart-to bill audits, identifies educational opportunities, and provides technical guidance to people who are in Biller/Coder Intermediate positions and below.• Uses appropriate, accurate, and professional communication techniques when addressing billing barriers.• Exhibits strong competency in use of all computer systems and applications that are commonly used for position.• Achieves the organization's established expectations regarding customer service, teamwork, and safety.• Fulfills all compliance responsibilities related to the position.• Performs other duties as assigned.
Requirements
• 5 years of experience required• Experience coding interventional cardiac catheterization lab and/or interventional radiology procedures, and diagnostic radiology tests• Data entry, MS Word, MS Excel skills• Experience in charge capture process or medical record review• Excellent verbal and written communication and analytical skills• Documented proficiency in use of ICD-10 and CPT-4 coding as required by position• Knowledge of how to accurately use ICD-10 and CPT-4 books• Sound knowledge of basic code structure is required• Strong analytical skills with attention to detail and a high degree of accuracy.
Key Skills Needed
• 5 years of experience• Experience coding interventional cardiac catheterization lab and/or interventional radiology procedures, and diagnostic radiology tests• Data entry skills• MS Word skills• MS Excel skills• Experience in charge capture process or medical record review• Excellent verbal and written communication skills• Analytical skills• Knowledge of ICD-10 and CPT-4 coding• Strong attention to detail and accuracy
