12 jobs found in Dayton

Medical Claims Specialist This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. Job Duties/Responsibilities Maintains a thorough understanding and education of federal and state regulations and payer specific policies and...

Professional Fee Coder Ensures the accuracy, efficiency, and maximum financial return of Dayton Children's professional billing claims for reimbursement. Ensures billing compliance; maintains knowledge of CPT and ICD-10 coding guidelines, as well as Medicare/Medicaid billing rules and regulations. Serves as a professional coding resource to providers and staff. The professional fee coder works a variety of work queues to ensure compliant professional fee coding. Work queues include, but are not limited to, Charge Review, Claim Edit, and Follow Up. The professional fee coder works directly with multiple providers to ensure compliant coding guidelines are being utilized. The professional fee coder maintains knowledge of CPT and ICD-10 coding guidelines.

Kettering Health Job Description Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach. Campus Overview Kettering Physician Network Our elite medical group employs more than 700 providers, including physicians and advanced practice providers, throughout the Greater Dayton and Cincinnati areas. Our patients have access to a multidisciplinary professional team to meet all their healthcare needs. From primary care to brain and spine surgery, we provide an extensive range of specialties and expertise, in over 200 locations and ten counties. Working collaboratively across specialties, we...

Professional Fee Coder Ensures the accuracy, efficiency, and maximum financial return of Dayton Children's professional billing claims for reimbursement. Ensures billing compliance; maintains knowledge of CPT and ICD-10 coding guidelines, as well as Medicare/Medicaid billing rules and regulations. Serves as a professional coding resource to providers and staff. The professional fee coder works a variety of work queues to ensure compliant professional fee coding. Work queues include, but are not limited to, Charge Review, Claim Edit, and Follow Up. The professional fee coder works directly with multiple providers to ensure compliant coding guidelines are being utilized. The professional fee coder maintains knowledge of CPT and ICD-10 coding guidelines.

KPN Pro Fee Coding Specialist This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Reviewing the ambulatory records for the appropriate risk adjustment components Identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10 Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy] Demonstrate initiative for maintaining current knowledge of CPT,...

Medical Biller/Collector - Onsite in Kettering, OH Overview A skilled nursing facility in Kettering, Ohio is seeking a detail-driven Business Office Manager to own resident billing, collections, and resident trust/ledger accuracy. This is a direct-hire, on-site opportunity for someone comfortable partnering with residents and families on financial responsibilities while keeping accounts receivable current and compliant. What you'll do Meet with residents and families to review coverage, explain balances, and set clear expectations on financial responsibility Manage private-pay collections and document follow-up activity on delinquent accounts to support clean A/R aging Bill and post monthly charges by pay source and internal close/calendar deadlines (Private Pay, Medicare, Medicaid, MyCare Buckeye, commercial insurance, Workers' Comp, etc.) Post payments promptly to resident ledgers and continuously reconcile for accuracy Complete monthly bank...

Medical Biller/Collector Onsite in Kettering, OH A skilled nursing facility in Kettering, Ohio is seeking a detail-driven Business Office Manager to own resident billing, collections, and resident trust/ledger accuracy. This is a direct-hire, on-site opportunity for someone comfortable partnering with residents and families on financial responsibilities while keeping accounts receivable current and compliant. What You'll Do Meet with residents and families to review coverage, explain balances, and set clear expectations on financial responsibility Manage private-pay collections and document follow-up activity on delinquent accounts to support clean A/R aging Bill and post monthly charges by pay source and internal close/calendar deadlines (Private Pay, Medicare, Medicaid, MyCare Buckeye, commercial insurance, Workers' Comp, etc.) Post payments promptly to resident ledgers and continuously reconcile for accuracy Complete monthly bank reconciliations and support month-end close...

LHH Talent - - Responsibilities: Meet with residents and families to review coverage, explain balances, and communicate financial responsibility in a professional and empathetic manner; Manage private-pay collections and document all follow-up activity on delinquent accounts to maintain accurate accounts receivable aging; Bill and post monthly charges by pay source in accordance with established timelines, including Private Pay, Medicare, Medicaid, MyCare Buckeye, commercial insurance, and Workers' Compensation; Post payments and reconcile resident accounts to ensure accuracy and completeness; Perform monthly bank reconciliations and assist with month-end close processes

Medical Claims Specialist This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. Job Duties/Responsibilities Maintains a thorough understanding and education of federal and state regulations and payer specific policies...

Job Title High School diploma or equivalency certificate. Three years of previous healthcare billing and collections experience preferred. Knowledgeable about third party billing regulations and CPT/ICD coding. Proficient computer and data entry skills. Effective problem solving skills and ability to work independently. Working knowledge of spreadsheet applications. Proven record of dependability. Effective verbal and written communication skills. Detail Oriented and ability to prioritize work. Effective time-management skills.

Health Information Management Services FULL-TIME / 8A-5P / 80 HOURS PER PAY Under the general direction of the Coding Supervisor of Health Information Management Services, this employee is responsible for the coding and abstracting of all Inpatient visits or Specialty Outpatient Surgery/Observation visits or both based on physician documentation in the Medical Record. He/she is responsible for collaborating with the Clinical Documentation Specialists to ensure appropriate documentation to validate accurate diagnostic and procedural information on each inpatient record. Accurate coding/abstracting and correct DRG or APC assignment is expected while adhering to the guidelines of the current coding classification systems and AHIMA's Standards for Ethical Coding. He/She is also responsible for following up on outstanding accounts for billing. All work is carried out in accordance with The Joint Commission on Accreditation of the Healthcare Organizations and Premier Health Partners...

ICD 10 CODER- OUTPATIENT 8A-4:30PM FULL TIME / 80 HOURS PER PAY PREMIER SYSTEM SUPPORT Under the general direction of the Coding Supervisor of Health Information Management Services, this employee is responsible for the coding and abstracting of all outpatient surgery visits, emergency room visits, clinic visits and ancillary testing visits. Coding/abstracting and correct APC assignment is included. Adheres to coding guidelines under current coding classification systems as well as other specialty systems as required by diagnostic category. All work is carried out in accordance with the Joint Commission on the Accreditation of the Healthcare Organizations and Health Information Management Services approved policies and procedures. Education: Associate Degree or Bachelor Degree in Health Information Management Services or within 90 days. Proof of completion of an approved ICD-10 course. Certification: RHIT or RHIA (or eligible). Experience: Knowledge of medical...