HealthCare Coding and Billing Specialist

Healthcare Coding and Billing Specialist

About Company

Samaritan Ministries is a Biblical solution to health care. It is not insurance. We deliver authentic, compassionate, and personal service in the name of Christ to enable and inspire members to provide for one another’s medical needs through prayer, encouragement, and financial support

.From demonstrating Christ-centered compassion to modeling best practices in health care sharing, Samaritan Ministries is committed to keeping Jesus at the center of everything we do. The way we interact with our colleagues and engage with our members is a testament that we are ultimately serving Christ and His Kingdom

.
Summa

ry
To serve the members of Samaritan Ministries International (SMI) through quantitative and qualitative contribution to the work of the ministry by performing a variety of tasks related to the ongoing maintenance and set-up of the medical bill adjudication syst

em.
Competen

• cies
  Acting with Integrity, Empathy, and Compa
• ssionCollaborating with O
• thersNeighbor
• FocusPursuing Excel
• lenceImproving Business Proc
• essesAnalytical Thi
• nkingProblem So
• lvingProduct and Technical Know
• ledgeSystems Integr

ation
Key Responsibi

• lities
  Staff are expected to meet established goals and clearly communicated expectations regarding both the quantity and quality of their work. They should demonstrate effective time management and prioritization skills, work independently with appropriate guidance from senior staff, and consistently apply training and acquired knowledge to fulfill their responsibi
• lities.Know the Healthcare sharing matching and allocation process from beginning
• to end.Create, troubleshoot and maintain medical bill adjudication system additions, terms, and c
• hanges.- Implement adjudication system upgrades which improve communication logic within the system pro
• cesses.- Configure and maintain the medical bill adjudication system mapping and all interface m
• odules.- Maintain medical bill adjudication system mapping parameters throughout the
• system.Collaborate to develop, implement, and improve cross-functional work processes which support adjudication and proper provider p
• ayment.Report on system, adjudication, and allocation perfo
• rmance.Review and analyze medical bills to ensure accurate application of ICD-10, CPT, and HCPCS
• codes.Conduct coding audits and quality assurance reviews to maintain compliance and ac
• curacy.Uphold member confidentiality and adheres to data security sta
• ndards.Collaborate with TPAs and internal member care specialists to resolve billing discrep
• ancies.Implement continuous quality improvement processes to help identify systemic issues in Bill/Needs processing and reduce
• rework.Support special pr

ojects.
Qualifications and Ex

• perience
  Bachelor’s degree or equivalent in ex
• perience.Medical Bill Auditing E
• xperienceReference Based Repricing experience (CMS, IPPS, Usual & Customary, Fee Sched
• ule etc.)CMS Coding and Billing Edits E
• xperienceAAPC Coding and Billing Certification (P
• referred)Staff are required to possess applicable knowledge to bring value to SMI in this role, know and utilize resources well, ask questions to ensure full understanding. gain and retain knowledge to keep up with changes, and accept and engage with training to grow knowledge for current and future responsi
• bilities.Knowledge and understanding of organizational structure especially of Validator and Member Care Specialist roles and respons
• ibilitiesKnowledge of Redeem Programs & G
• uidelinesFamiliarity of Healthcare forms such as HCFA
• s and UBsFamiliarity with EDI (83
• 7I, 837P)Familiarity with Healthpac or other Adjudication Platform e
• xperienceKnowledge of Vendor management E
• xperienceSoftware: Javelina, Sharable, HubSpot, others

as needed
Additional I

• nformation
  Tasks are normally conducted in a regular office environment, requiring use of computer and mouse and other standard office equipment. Staff usually remain in a stationary position, often standing or sitting for prolong
• ed periods.May need to lift and move items up to 35 lbs o
• n occasion.Staff will observe safety principles while performing the duties of th
• e position.Onsite staff will be required to travel to office and have a valid driver
• ’s license.Disclaimer: This job description is intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of responsibilities, duties and skills required of personnel in the classification. Work hours may be irregular, including performing duties on evenings o
• r weekends.This position requires an active commitment to the mission and values of SMI. In the course of performing job duties, the employee will act in a manner that is Christ-honoring as well as Christ-like, demonstrating a personal Christian faith and witness in all interpersonal in

teractions.Pay Range: $54,700-$79,800. Starting pay usually falls within the lower half of the pay range and is determined by experience, skills, and

education.Benefi

• ts Include:Performance-based in
• centive paySMI Membership with monthly healt
• hcare bonusHealth Insurance: MEC plan with employer HSA c
• ontribution401K Retirement plan with employer c
• ontributionLif
• e InsuranceShort-term
• disabilityDependent Care Flexible Spend
• ing AccountTime Off: 9 company paid holidays, 5 missions days accrued annually, maternity and paternity leave, FMLA, Bereavement, and weekly accrued PTO (40 hours to use after 30 days 80 hours accrued fo
• r 48 weeks)Health club or home workout benefits for particip
• ating staffFormal staff development and leadersh
• ip trainingSpiritual support and counseling through our staff sup
• port officeRepeatedly certified as a Best Christia