Coordinates and monitors reimbursement activities of an MFA Department. Trains physicians and staff in coding and billing in order to maximize revenue generation for the Department of Surgery.
Essential Duties and Responsibilities include the following. To perform this job successfully an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
Other Related Duties
- Abstracts professional and technical charges from clinical information on Emergency Department medical records for the purpose of patient billing.
- Analyze and interpret medical records to identify and assign CPT and ICD-9 codes on all billable services
- Assign and sequence appropriate diagnostic/procedure billing codes in compliance with Medicare and third party payors
- Review documentation to establish compliance with teaching physician billing guidelines
- Respond to billing and coding questions from providers, staff and administrators
- Review patient records and recommend appropriate coding/documentation for deficient records
- Provide coding overview and training to physicians and staff
- Analyzes end-of-month reports to provide information on the status of the department’s charges, allowances, bad debt and overall revenue; prepares appropriate billing reports and various summaries of billing activity.
- Investigates and suggests new revenue sources.
- Facilitates administrative control of the billing process through the coordination of related activities with appropriate departments.
- Acts as a liaison with third party carrier professionals regarding reimbursement issues.
- Assists physicians, staff and the MFA Business Office in the development of mechanisms to challenge claims as necessary.
- Reviews coding structures to ensure conformity with CPT requirements.
- Provides back up to reimbursement specialists in reviewing charges in TES work file.
Keep up-to-date on coding information by attending coding conferences, workshops and in-house sessions.
The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
High school graduation or an equivalent combination of training and experience is necessary. Certified Coder (CPC or CCS-P) required.
At least 3 years of professional coding.