Verifies and ensures the accuracy, completeness, specificity, and appropriateness of diagnosis codes on services rendered. Completes appropriate paperwork, documentation, and system entry regarding claim and encounter information. Supports and participates in process and quality improvement initiatives. Assists with clinician billing and documentation training.
Essential Functions
- Reviews medical record documentation to identify all services provided.
- Assigns appropriate CPT-4 procedure codes to accurately report clinician services provided.
- Assigns appropriate ICD-10 diagnosis codes to accurately support the need for each clinician service.
- Assists with the submission of billing.
- Obtains and submits copies of medical documentation with clinician charges to support billing to third-party payers.
- Identifies clinician services provided but not adequately documented and advises supervisors and clinicians of deficiencies to support charge capture of all billing services.
- Analyzes and resolves clinician claim rejects and denials from the billing system or insurance carriers related to coding.
- Assists with clinician billing and documentation training through daily interactions with clinicians and routine training.
- Compiles monthly reports as needed.
- Identifies trends and problems in medical documentation and recommends possible solutions.
- Provides training support to the billing department in handling rejections and denials.
- Corrects and submits reference lab billing requests.
- Performs other duties as assigned.
Additional Duties
- Assists in audits.
- Codes input forms as required.
- Provides backup support to the billing department.
Work Environment
- Smoking is prohibited in the work environment.
- Applicants must provide contact information for three references.
Requirements & Qualifications
Education
- Associate degree from an accredited Health Information Technology program required.
- Bachelor's degree preferred.
- Coding certificate with AHIMA approval status required.
- RHIA, RHIT, CCS, or CCS-P certification required.
Experience
- Three years of experience as a certified medical biller/coder.
- Federally Qualified Health Center (FQHC) experience preferred.
- Lab coding experience required.
Skills and Abilities
- Strong written and verbal communication skills.
- Strong analytical, organizational, and time management skills.
- Knowledge of billing and reimbursement in a healthcare environment, including Medicaid and Medicare.
- Knowledge of LCD/NCD coding policies regarding laboratory services.
- Ability to develop training materials for staff education.
- Professional demeanor and appearance.
- Strong ethics and a team-oriented attitude.
- Proficiency with Microsoft Word, Excel, and PowerPoint.
Location
St. Louis, Missouri, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 weeks ago
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