Responsible for assisting Coding Department and CBO in working charges on hold and denials to ensure optimum reimbursement based on accurate coding and meet all government-mandated procedures for Integrity and Compliance. Will assist in reviewing claims for accurate diagnosis and modifier usage. Will be required to reach out to senior coders for guidance when they are unsure or presented with a situation that is above their experience level. Will assist the Charge Capture Specialist in gathering and scanning documents to Senior Coders for coding and charge entry. 1 year from date of hire, employee will be required to take the internal test for movement to Coding Specialist.
EDUCATION: High school diploma or equivalent.
CERTIFICATION/LICENSES: CPC (desirable) or CPC-H. Will be required to obtain their AAPC ICD-10 Certification within a reasonable amount of time as applicable.
Excellent written and verbal communication skills.
Detail and results oriented.
Ability to work independently and know when to ask for assistance
Medical terminology, ICD-9 (ICD-10), CPT-4, HCPCS knowledge required.
Must have proficient knowledge of Medicare, Medicaid and other third party payer documentation, coding and billing regulations for service lines (s) assigned.
Knowledge of CMS 1500 form locator requirements. Familiarity with billing requirements and claim submission processes for Fiscal Intermediary, Carrier and major insurers.
Must possess excellent organization and planning skills, including the ability to prioritize multiple tasks and perform them both accurately and simultaneously.
Must possess strong written and verbal communication skills in order to communicate in clear, concise terms to management at all levels, including the ability to communicate regulatory information in layman's terms.
Must possess a personal presence of highly qualified professional that is characterized by a sense of honesty, integrity and the ability to support the mission of the organization.
Requires detailed knowledge of healthcare billing and coding in terms of what and how work is to be done as well as why it is done, this level includes interpretation of data.
Ability to exercise choice in how work is accomplished with independence to operate within established policies, procedures and schedules.
Be open to the challenge to learn in the first year EM and procedural coding for multispecialty physician practices.
EXPERIENCE: Must have1 year experience as a CPC in diagnosis coding, and denial management in physician practice or hospital setting. At least 3 years' experience of billing or denial management in lieu of 1 year experience as a CPC.
NATURE OF SUPERVISION:
-Responsible to: CSVMG Director of Coding and Revenue Cycle
- Bloodborne pathogens - A
General office environment. Knowledge of general safety standards. Exposure to hazards from electrical/mechanical/power equipment.
PHYSICAL REQUIREMENTS: Continuous sedentary position with intense mental concentration up to 7.5 hours per day, using sound ergonomic principles. Data entry up to 7 hours a day. Light physical effort (able to lift/carry up to 10 lbs.) Occasional reaching, stretching, bending, kneeling.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.