Coder and Biller

54036E

Under the direction of the Administrator, Insurance and Charge Posting Manager, the Biller and Coder

is responsible for reviewing encounters in the practice management system (e.g., Cerner) and RCx Rule

making corrections as needed in accordance with applicable guidelines. Manually charge entry of multiple

service lines in IDX. Work also includes inputting encounters and other source documents received from

clinics in an accurate, compliant, and timely manner. An incumbent engages in various charge capture

tasks/initiatives to ensure charges are entered, edited, and billed in a timely and efficient manner to

maximize revenues and serves as a resource to other staff and billing departments for complex charge

review/entry issues. Preparing and analyzing reports. Front end reconciliation process. Manual payment

posting and analyzing Phreesia stale payment. Providing feedback to providers and MA with billing errors.

Training of new and existing teammates. Responsible for seeking resolution to problems relating to

charge entry and ETM Edits. Insurance verification.

Work requires considerable understanding of CPT and diagnosis codes, ICD-9/10 coding, anatomy, and

physiology as it relates to the medical field. Effective troubleshooting skills are required to facilitate

consultation with multiple team members to address and resolve issues having a potential impact on

revenues.

Qualifications

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

• Review encounters and making corrections as needed in accordance with guidelines.

• Input encounters and other source documents received from clinics

• Prepare and analyze reports

• Seek resolution to problems relating to charge entry and ETM edits

• Engage in varopus charge capture tasks/initiatives to ensure charges are entered, edited, and billed in a timely and efficidnt manner to maximize revenues

• Serves as a resource to other staff and billing departments for complex charge issues

Closing Statement

About Jefferson

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University , home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health , nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

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