Certified Coder and Surgical Scheduler

The Women’s Group of Northwestern is an independent practice located on the Magnificent Mile with a satellite office in Northbrook. Our staff of 18 providers (MD’s, Physician’s Assistants and Nurse Practitioners) deliver the highest level of patient care and patient satisfaction. If you are an experienced Certified Medical Coder & Surgical Scheduler, we would love to meet you! (MUST HAVE EXPERIENCE WITH SCHEDULING SURGERY & HOLD A CERTIFIED CODER LICENSE)

Our team of staff members work together to give our best to our patients and to each other. Our leaders are committed to ensuring that you are successful in everything you do and want you to understand how much we value you. We offer a highly competitive salary, excellent benefits including 3 weeks of PTO per year, a 401K with profit sharing, and an environment that respects you as a professional.

If you have experience providing stellar customer service in a medical setting, excellent prior performance and attendance, and experience with Epic/Epic Op-Time or Athena, we are ready to take your career to its highest levels, please respond to our posting with your resume and your desired salary.

POSITION SUMMARY

Perform a variety of medical and business office support functions related to documenting patient medical and financial information, scheduling surgeries in patient and office, billing out patient claims, and perform all patient eligibility verifications as indicated.

ESSENTIAL FUNCTIONS

• General:
• Monitor, track and organize all incoming surgery requests from clinicians.
• Handle internal and external patient calls from staff, patients, insurance companies, and outside billing service if applicable.
• Utilize NMH system and Athena Health to schedule all patients surgical cases in accordance with patient physician preferences and availability and practice protocol.
• Coordinate all GYN procedures and/or surgery for inpatient/outpatient hospital, surgery center, in-office and include Mobile Anesthesia if applicable.
• Accurately enter patient cases into NMH scheduling system
• Communicate to the OR team to the appropriate surgical procedure and any special equipment or needs that each case requires.
• Coordinate preoperative testing (including but not limited to lab tests, diagnostic test, and intraoperative tests).
• Notify all parties involved regarding time changes with schedules.
• Represent practice in a professional manner. Treat all customers, internal and external, in a courteous and cooperative manner.
• Attend scheduled staff meetings and participate with team activities and professional development activities.
• Develop and maintain effective and open working relationship with outside billing company (if applicable).
• Aid main biller in coding and billing of OBGYN patient claims.
• Payment processing:
• Charge Posting with accuracy in the EMR.
• Identifies denied/non-payable charges and acquire approval for write-off.
• Communicates regularly with providers and outside billing company staff on clarification to accurately code diagnosis and procedures. And to provide coding guidance as needed.
• Administers all outside billing company (if applicable) pending claim reports, reviews all documentation for coding accuracy, researches and give instruction to resubmits rejected and denied claims. Provide any additional information requested.
• Understands and applies commercial insurance reimbursement principles for proper submission of claims.
• Monitor and report identified trends affecting claim reimbursements as directed by department manager.
• Assists in educating providers on billing issues identified through ongoing reviews of submitted charges in conjunction with Billing Office Manager.
• Analyze coding:
• Scrub superbills and documents, to ensure correct ICD-10 codes are appended. Ensure that all billable procedures are captured accurately, timely and completely.
• Use current coding conventions and guidelines, codes and abstracts medical records for reimbursement purposes from patient charts, provider’s documentation, and medical diagnostic and/or interventional reports.
• Works effectively with physicians to ensure accurate coding and to provide coding guidance as needed.
• Reviews individual medical records to verify and substantiate diagnosis and procedures for charge review, claim edit(s) and/or denied claims.
• Ensures the timely accomplishment of all ICD-10 development and milestones.
• Identifies coding and billing errors and analyzes the source of error to prevent future reoccurrence.
• Responds to medical coding claim concerns and collaborates wit team or providers to ensure all concerns are resolved within a timely manner.
• Reviews claims to identify errors and ensure appropriate correction and resubmission of claims as needed.
• Participates in coding roundtables and in-service for continuous education. Cross trains and provides back up coverage of team members to ensure continuous coding and charge capture activities for provider group.
• Obtain and verify patient medical insurance eligibility and benefits:
• Utilize insurance websites and/or other online resources for insurance benefit verification.
• Verify insurance benefits and pre-cert if required for outpatient/inpatient procedures.
• Assist in patient interaction:
• Welcome and greet patients/clients/visitors to the department in a manner that is helpful and friendly; determine purpose of visit and direct patients/clients/visitors to appropriate person or department.
• Inform patient of benefit coverage, and collect any deductible, co-insurance, and/or copayment, before procedure is performed.
• Collect patient’s financial agreement form which requires a valid credit/debit card and signature on file.
• Collect patients outstanding balances when patient call to discuss this accounts.
• Ensure that patients receive appropriate instructions surrounding their surgery/procedure.
• Ensure HIPAA compliance and PHI guidelines at all times; Ensure The Red Flag Patient Awareness Policy and practices are adhered to.
• All other duties as assigned.

Job Type: Full-time

Pay: $20.00 - $30.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Education:

• Bachelor's (Preferred)

Experience:

• Medical Billing and Insurance Claim Coding: 2 years (Required)
• Inpatient Hospital Surgery Scheduling: 2 years (Required)

License/Certification:

• Certified Professional Coder (CPC) Certification (Required)

Work Location: In person

Salary : $20 - $30