Biller and Coder

Position Title:                        Billing Coder

Department:                          Revenue Cycle/Billing

Position Reports to:              Revenue Cycle & Billing Manager

Position Summary:

 Review medical records utilizing ICD-9 and ICD-10 and CPT coding conventions. Audits medical records to ensure specificity of diagnoses and procedures, and to ensure appropriate and optimal reimbursement from proper payer types.

Responsibilities:

• Analyze medical records and ensure all appropriate International Classification of Disease (ICD-9 & 10) and /or current Procedural Terminology (CPT) coding for billing of proper patient programs.
• Enter and retrieve patient medical data from EPIC-Ochin System updating entries as necessary; audit medical record for accuracy and completeness, note deficiencies and refer for appropriate follow up and completion.
• Consult with physicians and other personnel on coding practices and conventions to provide detailed coding information or gather additional documentation; maintain comprehensive records of all communications regarding suggested changes.
• Research and initiate activity to resolve charges and coding issues, review difficult situations to determine the most appropriate codes.
• Recognize potential for additional coding revenue and initiate the change in the EPIC-Ochin System.
• Enter charges as recorded by back office or clinicians with in a timely manner; charges should be posted with 48 hours of patient visit.
• Post payments to patient’s accounts within a timely period, review all denials and resubmit to correct payer.
• All denials need to be investigated and follow up notes entered into the MIS System of any changes.
• Review and track payments of all submitted billing, reconcile visits and payers records on a weekly basis.
• Assist patients on program eligibility and on billing information.
• Handles special projects and other duties as requested. 

Qualifications/Requirements:

• Highs School graduate or equivalent.
• Associate Degree or two years of HIT college level coursework preferred
• Knowledge of Medical Terminology and Anatomy & Physiology required
• Knowledge of Title 22 medical record regulations preferred
• Knowledge of Confidentiality and rules regarding HIPAA and State and Federal governing release of medical information required
• Minimum two (2) years of continuous, relevant ICD/CPT coding experience in an acute care facility within the last five (5) years is required
• System oriented experience in use of computerized medical records abstracting, encoding and database systems