BILLING/CODING COORDINATOR

JOB SPECIFICATIONS:

• To proceed with job performance within the limits of established policies and procedures and report all problems that result in the inability to perform those duties to your immediate superior. Billing and coding experience or Nursing experience preferred.

QUALIFICATIONS:

• High school graduate with courses in English, general mathematics, and computers recommended, but not mandatory.
• Must be able to communicate well, maintain a positive and professional attitude while performing normal daily job functions, and have the ability to work with other employees in order to effectively produce desired workflow.
  
• Five years’ experience in an in-patient or out-patient medical setting, or health care business office.
• Knowledge of patient accounting systems, claims filing systems, insurance, and other third- party reimbursement, possess leadership to associates and other staff members as needed.
  
• Possess the ability to make independent decisions when circumstances warrant such action and follow administrative guidelines.

PHYSICAL REQUIREMENTS:

• Must have personal integrity, flexibility, and ability to work effectively with other
• Must be able to sit, bend, and move intermittently throughout the
• Must possess the use of arms, hands, legs, feet, sight, and hearing senses or use prosthetics that will accommodate these functions adequately, so that the requirements of this position can be fully met.
• Must possess sight/hearing senses and the use of arms, hands, legs, and feet or use prosthetics that will accommodate these functions adequately, so that the requirements of the job can be fully met.
  
• Must be in general good health.
• Must be able to ambulate effectively to all areas of the hospital for patient review and follow-up.

JOB DUTIES AND RESPONSIBILITIES:

• Oversee the procedure mnemonics in Meditech, following guidelines outlined in the dictionaries in charge entry, charge capturing, and charges auditing.
  
• Keep current with any charge changes and apply such changes in the chargemaster.
• Assist the Tombigbee Healthcare Authority administration and Rural Health Clinic staff in CPT and ICD-10 coding and billing practices as to your certification's qualifications.
  
• Concurrent follow up with insurance payors and appeals determinations.
• Provide advice and opinions to other departments involved with the billing and coding denials and appeals process in their departments.
• Perform claims management and compliance with carriers and stay updated on changes as they occur, followed by education of the necessary departments within the facility.
  
• Update facility departments of coding and billing changes, provide written “clip notes" guidelines as to new charge entries into the EMR as necessary.
• Keep up with registration processes with the understanding that patient registration is the first capture of vital patient Maintain usable and applicable knowledge in the patient check-in and check-out processes.
  
• Follow closely with back-end patient collections from various payors, private companies, charities, indigent, and self-pay entities and/or individuals.
  
• Maintain logins to as many carriers as possible in order to delve deeper into the payor's rules and regulations, and billing allowances.
  
• Perform periodic reimbursement analysis, medical compliance changes, and financial audits as deemed necessary by the Executive Director.
• Maintain good relations on behalf of your department, its personnel, and the hospital, and take every opportunity to enhance the quality of the customer experience.
• Maintain a current updated billing reference for Medicare, Medicaid, Blue Cross, etc., to include manuals, letters, and memorandums, of a policy nature or changes.
• Demonstrate competence to assess, distinguish, report, and act upon the physical, social, developmental, and environmental needs for delivering care and services to the following age-specific groups, infant, pediatric, adolescent, adult, and geriatric.
• Monitor problems or systematic needs within your department and report to the Executive Director.
• Report any customer complaints or ideas for improvement to the Performance Improvement Committee members.
• Perform any necessary duties requested by the Executive Director.