Reports to the Manager of Professional Coding. Under general supervision and in accordance with the policies and procedures established by BMG Professional Coding, reviews and accurately codes office and hospital procedures for reimbursement requiring exercise of initiative and judgement.
Mission, Values and Service Goals
Mission: We deliver outstanding care, inspire health, and connect with heart.
Values: Trust. Respect. Integrity. Compassion.
Service goals: Personally connect. Keep everyone informed. Be on their team.
Responsibilities
Perform routine and non-routine revenue cycle, billing, coding and insurance functions, such as extracting relevant information from patient records, examining documents for missing information, liaising with physicians and other parties to clarify information.
Analyze documentation and accurately apply CPT, ICD, and HCPCS codes to support compliant coding.
Work with rejected and denied claims based on assigned reports, and assist in complex denial resolution.
Communicate updates on coding-related changes and billing opportunities and guidelines to supervisor and/or providers.
Assist providers with required documentation, compliant coding, and reimbursement.
Monitor provider documentation for trends and adherence to documentation standards and regulatory requirements through report and billing analysis, communicating results to providers and management as needed.
Participate in timely review of provider documentation and communication of results to supervisor.
Audit reports as necessary to identify and correct coding-related errors.
Achieve BMG's coding productivity and accuracy rates within 6 months of hire; maintain rates as evaluated by internal or external review.
Work closely with other BMG Central Business Office associates.
Present coding and compliance related topics to team members.
Complete other job-related duties and projects as assigned.
Organizational Responsibilities
Attend and participate in department meetings, and be accountable for all information shared.
Complete mandatory education, annual competencies and department specific education within established timeframes.
Complete annual employee health requirements within established timeframes.
Maintain license/certification, registration in good standing throughout fiscal year.
Direct patient care providers maintain current BCLS (CPR) and other certifications as required by position/department.
Consistently utilize appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
Adhere to regulatory agency requirements, survey process and compliance.
Comply with established organization and department policies.
Be available to work overtime in addition to working additional or other shifts and schedules when required.
Commitment to Beacon's Six-Point Operating System (The Beacon Way)
Leverage innovation everywhere.
Cultivate human talent.
Embrace performance improvement.
Build greatness through accountability.
Use information to improve and advance.
Communicate clearly and continuously.
Education and Experience
High School diploma, GED or suitable equivalent; graduate of an accredited medical coding program preferred.
Two years physician coding experience in an applicable specialty preferred.
Designation as a Certified Coding Specialist-Physician Based, Certified Professional Coder, Certified Medical Coder, or Certified Coding Associate required.
Must complete a minimum of 12 hours of coding related education per year in field of concentration.
Knowledge & Skills
Accuracy and proficiency with CPT, ICD and HCPCS code assignment.
Knowledge of regulatory and payer specific coding guidelines.
Proficiency in anatomy, physiology and medical terminology.
Exceptional organizational skills and attention to detail.
Proficient computer skills in data entry, coding, knowledge of Electronic Medical Record software; Microsoft Office Suite.
Ability to work independently and as a member of a team.
Excellent communication skills, both oral and written, to effectively speak to a diverse audience.
Working knowledge of HIPAA and ability to maintain confidentiality of all data.
Working Conditions
Works in an office environment.
May experience some mental/visual fatigue from careful and constant review of records, code books, and continued use of computer equipment.
Physical Demands
Requires physical ability and stamina to perform the essential functions of the position.
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