Serve as a data analyst in the Resource Management element in the Business Operations & Beneficiary Services (BOBS) Flight with primary responsibilities associated with 673 Medical Group, Joint Base Elmendorf-Richardson, Alaska. Specific responsibilities include:
Provide data to help develop systems and processes that will allow both organizations to collaborate together on staffing requirements.
Skill in applying basic data gathering methods, such as standard interviewing or surveying techniques, to collect various types of factual information.
Apply knowledge of the standardized processes and procedures for evaluating management or program operations to perform duties such as planning the steps to take to complete assignments; identifying problems form collected data and selecting solutions from alternatives in guidelines and precedent cases.
Plans and carries out the successive steps of management or program analysis technical projects and assignments and handles problems and deviations in accordance with instructions, policies, previous training, or accepted practices.
Independently determines the types and sources of management or program information required for reports, the nature and extent of deviations from established management or program requirements, and whether standard data gathering techniques are appropriate for assignments.
Monitors changes in billing rates of various fees schedules to ensure billing software is up-to-date with the most current fee schedules.
Creates billing claims in Medisoft billing system and prepares reports reflecting the entries are accurate and balance with the monthly summary excel document.
Processes billing claims according to 673 MDG billing protocol and Joint Venture Sharing Agreement.
Reviews bills and diagnostic coding to assure accuracy and compliance with regulatory requirements; identifies deficiencies such as omissions and incorrect use of medical terminology, and corrects records as necessary.
Codes, reviews, analyzes a variety of medical records and diagnoses, consulting with lead coder and providers to ensure records are correct and complete; sequences multiple diagnosis codes are primary and secondary and identifies that all charges and coding are consistent with patients’ diagnosis and type of care.
Ensures all VA patient record documents are present for review in Computerized Patient Record System (CPRS) for health care services provided and billed through 673 MDG. Provides clinical results when information is not available in CPRS and for all outpatient specialty clinics, pathology and radiology.
Builds computer files for ICD9 and CPT codes and enters current information into Medisoft billing system.
Develops processes and compiles data from pertinent records and provides information to DoD administration to assist in special studies or projects.
Maintains and reconciles accounts, prepares reports and statements, analyzes accounts and follows-up on delinquent accounts.
Posts payments to accounts into the Medisoft billing system and reviews for accuracy. Prepares documents reflecting the entries within various reporting frames.
Maintains fee schedules and updates Medisoft billing software to reflect current Champus Maximum Allowable Charge (CMAC) pricing.
Performs necessary research and documents correctly to determine whether the patient should be billed as a retiree or veteran beneficiary.
Knowledge is mandatory of medical terminology, laboratory, pathology and radiological studies, and pharmaceuticals in order to accurately analyze medical records. Must have knowledge of Medical Insurance Billing and Coding and comprehensive understanding of CPT/Coding and ICD-9 guidelines. Must be able to interpret and apply billing and coding guidelines in accordance with national standards. Must have knowledge of the Right to Privacy Act and other regulating directives on release of information. Must have knowledge of medical records, procedures, regulations, and principles to perform functions such as analysis, processing claims, coding and compiling data. Must have knowledge of medical terminology, laboratory, pathology and radiological studies, and pharmaceuticals in order to accurately analyze medical records and bill accordingly. Must have ability to research and apply billing guidelines to produce a claim according to the national standards set forth by Center for Medicare Services (CMS). Knowledge of the Joint Venture, DoD Fee Basis processing and payment regulations and applicable contracts preferred. Must have comprehensive understanding of Current Procedural Terminology (CPT)/ Coding and International Classification of Diseases 9th (ICD-9) guidelines.
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