Job Description

Aultman Medical Group/Professional-Senior Billing Specialist

 

Position Summary

 

The primary responsibility of this position is to review, analyze and/or assign ICD-10 Diagnosis and CPT Codes for all E & M, procedural and/or surgery codes for professional billing.  Also, should be able to code for Professional Inpatient vs Observation status. Other responsibilities include revenue integrity functions including charge capture, timely charge entry, revenue improvement initiatives and compliant documentation review.  Job function include communicating with practice leaders, providers and CBO leadership on areas of concern or opportunity including open encounters and zero charges.

 

Candidate may also be expected to assist in performing other administrative task as assigned as well as assisting other areas of the Revenue Cycle or Clinical divisions as necessary.

 

Primary Responsibilities

Proficiently assign ICD-10, HCPCS, CPT codes and modifiers to all assigned outpatient or inpatient records for all professional coding for AMG and hospital-based providers Proficiently analyze ICD-10, HCPCS, CPT codes and modifiers to all assigned outpatient or inpatient records for all professional coding for AMG and hospital-based providers Audit medical record for missing documentation, incomplete tasks, unordered codes to prevent loss of revenue Apply all NCD, LCD, MUE and CCI guidelines when coding or analyzing Code to the highest specificity and educate provider when unspecified code is used but documentation supports a more specific code Verify providers are capturing quality indicators and educate if missing Maintain suitable knowledge of coding, compliance, governing bodies, and reimbursement policies according to the coding related to the specialty assigned to code. Responsible for open encounters and zero charge communication and tracking Effective verbal and written communication with office staff, providers and AMG leadership Meet/Exceed established productivity expectations Meet/Exceed established quality expectations Perform additional administrative tasks as assigned Maintain attendance according to departmental standards Meet/Exceed internal CEU hourly requirements Complete safety evaluation, JCAHO education, Confidentiality, Information system usage, HIPAA corporate compliance education on an annual basis. Exhibit excepted level of team work and respect

 

Desired Job Qualifications/Skill Sets

1-year minimum coding experience in a Physician office or Outpatient hospital setting mandatory.  Abstraction of codes preferred RHIA, RHIT, CCA, CCS or CPC required preferred but not required Additional certifications helpful Knowledge of accounts receivable goals and impacts. Ability to establish and organize daily work flow. Solid computer skills (Microsoft office, encoder and other hospital software applications Ability to manage multiple demands from a variety of constituents