Coding And Billing Specialist
Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.
A Brief Overview
Responsible for the daily coding and billing operations of the clinics as assigned.
What You Will Do
- Assign appropriate codes using CPT, ICD-10 and HCPC's for all charges according to national and payor guidelines and physician direction.
- Work with physicians and clinic management staff to resolve coding and reimbursement issues and patient concerns.
- Communicate coding updates and changes to appropriate individuals.
- Coordinate and/or complete insurance appeals on denied claims due to coding issues.
- Assist in the design of charge documents for the clinic and maintain documents with the most current coding information.
- Ensure maximum third party reimbursement through financial planning, familiarity with payor contracts and pursuit of appropriate reimbursement on all claims.
- Investigate and report on all current reimbursement developments on third party payor functions when unable to resolve them and their remittances.
- Review all insurance bulletins and refers information to other personnel as appropriate.
- Provide support to clinics during periods of increased workload, periods of transition, or on an as needed basis.
Essential Qualifications
The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.
Required Education, License/Certification, or Work Experience:
- Associate's in Coding or Health Information Management and/or 1-2 years relevant experience and/or current certification as a coding specialist.
- AHIMA Membership - American Health Information Management Association (AHIMA) within 1 Year or
- Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) within 1 Year or
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) within 1 Year or
- Registered Health Information Tech (RHIT) - American Health Information Management Association (AHIMA) within 1 Year
- 1-3 years Coding or patient account experience or outlined degree or certification.
Expectations and Standards
- Commitment to the daily application of Avera's mission, vision, core values, and social principles to serve patients, their families, and our community.
- Promote Avera's values of compassion, hospitality, and stewardship.
- Uphold Avera's standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
- Maintain confidentiality.
- Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
- Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.
Benefits You Need & Then Some
Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.
- PTO available day 1 for eligible hires.
- Up to 5% employer matching contribution for retirement
- Career development guided by hands-on training and mentorship