CODING AND VERIFICATION BILLING REPRESENTATIVE

Brief Description

CODING AND VERIFICATION BILLING REPRESENTATIVE

Job Type: Full-time, non-Exempt

Schedule: Monday–Friday, day shift;

Location: Mishawaka, Indiana

Benefits

We offer a comprehensive benefits package for eligible full-time employees, which includes:

• Medical, dental, and vision insurance
• Health savings and flexible spending account options
• Retirement plan with employer contribution
• Employer-paid life and accidental death & dismemberment (AD&D) insurance
• Employee assistance program (EAP)
• Wellness and healthy lifestyle benefits
• Employee peer recognition program
• Annual anniversary/retention bonus opportunities
• Competitive paid time off (PTO)
  
  

Full details of benefits and specific eligibility (including any minimum scheduled hours for certain benefits) are provided during the interview and onboarding process.

Essential Functions

ICD-10 Coding:

• MHIN – Download patient records – History/Physicals, Consults, Laboratory.
• Download last few days of progress notes from General Hospitals or call for records.
• Code with appropriate ICD-10 codes.
• Supply all paperwork and coding to admission nurses in a timely manner.
• Call Doctor’s offices when needed for records.
• Research all coding errors on Medicare claims and correct coding in Cerner.
  
  

Benefits Verification

• Verifies medical benefits for Medicare and Medicaid.
• Utilizes MHIN for demographics and insurance information.
• Works closely with referral specialists and Intake Coordinator as necessary for coverage.
• Works with designated staff to communicate/coordinate details of client coverages.
• Follows procedures to input verification information into Cerner and communicates information to Admissions.
  
  

Chart Closing

• Closes Medicare and Medicaid charts.
• Verifies A/R account for payment in full.
• Verifies all proper forms are in charts.
• Completes pink chart closing paperwork.
• Maintains an accurate filing system in the closed chart cabinets.
  
  

Administrative Duties

• Organizes and maintains accurate filing system in discharge, open and staging areas.
• Files LOC print-outs and completed Certifications of Terminal Illness (COTI) in patient charts.
• Maintains discharge charts: noting date discharged, and filing charts alphabetically.
• Opens and date stamps all Medicaid Notification letters and scans the approved and discharge notifications into the patient’s chart in Cerner.
• Puts all letters in the Medicaid Billing Representative’s mail tray and then files all letters in patient’s charts when returned to Billing Assistant’s mail tray.
• Serves as Receptionist as needed at the Center for Palliative Care.
  
  

Additional Functions

• Committed to Agency resolution against fraud and abuse.
• Knowledgeable in hospice philosophy and state and federal rules and regulations.
• Arrives to work and meetings on time and ready to work.
• Respects confidentiality of patients/families and other Agency employees.
• Attends educational meetings/conferences for professional growth as required.
• Sees change as an opportunity and maintains a level of flexibility which allows for adaption to new ways of performing.
• Follows directions and policies that allow for an organizational commitment to working under time pressures without sacrificing quality.
• Performs other duties that may be assigned.
  
  

Job Requirements

Possess the following abilities:

• Speak in ordinary conversational tones utilizing the English/American language.
• Hear ordinary conversations.
• See with the visual acuity necessary to perform the Essential Functions listed in this Job Description.
• Have simultaneous use of hands, wrists, and fingers (example: writing, typing, data entry)
  
  

Qualifications

• High School Diploma
• Medical coders must be knowledgeable about government regulations and insurance payer policies on healthcare and ensure that the coding system meets acceptable standards.
• Minimum of 1 year working with ICD-10 codes.
• Experience working with private insurance companies, Medicare and Medicaid. .
• Strong computer skills required.
• An ability to organize and prioritize work tasks.
• Possesses excellent communication skills.