Hawaii Island Community Health Center

Job Title-Billing Coder

Supervised By-Billing Manager

POSITION FUNCTION SUMMARY

Under the general direction of the Billing Manager, the Billing Coder is responsible for the timely completion of all billing functions including maintaining accurate record of all patient accounts, recording charges, payments, submitting reimbursement requests to all payers, following up on any denials, and provide backup eligibility services. The Billing Coder works closely with the front office and providers on staff to insure accurate and timely information.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This position may have various work assignments within HICHC. This description is intended to be generic in nature, and as such it does not detail all duties and responsibilities of the job assignment. Various duties, responsibilities and accountabilities may be assigned to an incumbent in this position depending on clinic needs, and may include but not be limited to the following:

• Complies with medical coding guidelines and policies ensuring that codes are assigned correctly and sequenced appropriately as per government and insurance regulations.
• Ensures the timely input of patient billing data into the computer system with few errors.
• Maintains patient account information and updates as necessary including new service and billing information, payments received, and patient demographic information.
• Ensures proper billing of patient charges to various payers.
• Prepares monthly and weekly reports as requested.
• Prepares outgoing patient billing statements according to the pre-established schedule.
• Maintains a record of all collections.
• Monitors accounts receivable and reprocesses claims as necessary to maximize revenue.
• Counsels patients in setting up payment plans to recover outstanding balances.
• Requests refunds to patients when there are overpayments.
• Recommends policies and procedures that will improve performance of the billing department and help maximize revenue collection.
• Updates CPT and ICD-10 codes at least yearly as directed.
• Monitors HICHC fee schedules and recommends updates, when identified.
• Maintains insurance information on all providers and up-dates when necessary.
• Provides back up to eligibility/verification position, as needed.
• Provides feedback to clinic operations staff and medical providers to ensure appropriate coding of encounters.
• Communicates and works closely with front office staff.
• Other duties as assigned.

POSITION SPECIFICATIONS Requirements of Position

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and Experience

• High School graduate or GED certificate and two years related experience and/or training in medical billing is required; OR any equivalent combination of experience, training and/or education.
• Holds and maintains an active coding certification.

Knowledge, Skills and Abilities

• This position requires a basic knowledge of general office procedures to include filing, copying, and faxing.
• Ability to use a computer to enter patient data and retrieve information in a patient billing system.
• Knowledge of collections procedures, CPT and ICD-10 codes.
• Detail oriented with demonstrated organizational skills in creating and maintaining file system.
• Experience with basic bookkeeping.
• Ability to work on multiple tasks within established deadlines.
• Ability to work under the direction of a supervisor and follow instructions.

Language Skills

• Ability to read and interpret documents such as government regulations and guidelines, payer contracts, patient records, operating and maintenance instructions, procedure manuals, etc.
• Ability to write at a level of competence, including internal reports and memoranda.
• Ability to communicate with diverse groups of people to include staff and providers and patients.
• Ability to communicate effectively with patients and their families to make their visit a pleasant experience.
• Sensitivity to the multicultural nature of the service area population and may be required to communicate in another language.

Personal Characteristics

Personal characteristics include: a team player, high integrity, multitasker, communication and customer relations skills, regular work attendance, courteous and friendly, able to work well with diverse groups of people, gain and maintain the respect of others, accept HICHC mission and values.