Billing and Coding Specialist

Billing and Coding Specialist - Clinics

Singing River Pediatrics - Pascagoula | Full-Time | Monday - Friday 8-5 |

Pascagoula, Mississippi

United States

Position Overview

The Billing and Coding Specialist compiles all bills and diagnosis codes. They summarize the data for submission to the billing entity and verifies the existence of the documentation, which supports billing intentions on the patient chart. The Billing and Coding Specialist analyzes and interprets patient medical records to identify and determine amount and nature of billable services.

The Billing and Coding Specialist assigns diagnosis-related groups (DRGs) and ambulatory payment classifications (APC's); completes abstracts for patient data; and works with all medical records regarding coding diagnoses and procedures. They ensure the accuracy and completeness of assigned diagnosis and procedure codes and validates against the clinical documentation and claim data, establishing principal/first listed diagnosis and secondary diagnoses. Expectation is for all performed duties to be in accordance with Singing River Health System procedures and policies, accreditation organization, and governing guidance and publications for health care employees.

DISCLAIMER: This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this intends to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks performed as assigned.

Education:

High school diploma or equivalent required. Completed course work in medical terminology, anatomy, physiology, disease processes, ICD-9/10-Clinical Modification coding, and/or CPT coding preferred.

License:

N/A

Certifications:

Certification by the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) preferred:

* CPC: Certified Professional Coder;
* COC: Certified Outpatient Coder
* CCP: Certified Professional Coder
* Or other equivalent coding certification.

Once certified, employee must complete all requirements (including continuing education) to maintain certification.

Must have de-escalation training completed by the end of position orientation (90 days); must have appropriate level of de-escalation training.

Experience:

A minimum of two (2) years' experience in a medical records' department, cash posting in banks or other related companies preferred; medical coding and knowledge of DRGs/APCs/ICD10 preferred. Experience with a code finder and medical terminology preferred.

Reports to:

Practice Administrator; Manager; Supervisor

Supervises:

None

Physical Demands:

Work is mainly sedentary: involves sitting most of the time with regular requirements to move about the office, move about the facility, and to travel to another facility within the SRHS service area. Work involves exerting a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.

Work involves using many physical motions in performing daily work activities; subject to exposure of body fluids, sputum and tissues, which may carry the hazard of infectious disease. Work involves using repetitive motions: substantial movements of the wrists, hands, and or fingers while operating standard office equipment such as computer keyboard.

Work involves being able to perceive the nature of sound at normal speaking levels with or without correction; the ability to make fine discriminations in sound. Work requires close visual and acuity and the ability to adjust the eye to bring an object into sharp focus, i.e. shift gaze from viewing a computer monitor to forms/printed material that are closer to compare data at close vision.

Must be able to be active for extended periods of time without experiencing undue fatigue. Must be able to work schedules assigned with the understanding that changes may be instituted according to the needs of the hospital for off days, shifts or weekends.

Mental Demands:

Must demonstrate keen mental faculties/assessment and decision making abilities. Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone. Must demonstrate strong written and verbal communication skills. Must possess emotional stability conducive to dealing with high stress levels. Must demonstrate ability to work under pressure and meet deadlines.

Attention to detail and the ability to multi-task in complex situations is required. Must have the ability to maintain collaborative and respectable working relationships throughout SRHS and other organizations

Special Demands:

Must possess superior customer service skills and professional etiquette. Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.), MS Outlook and Word.

Must be able to demonstrate appropriate clinical judgment and apply appropriate professional skills to a patient population of all ages.

Must have knowledge of anatomy, physiology and medical terminology; and have knowledge of DRGs/APC's.