Located in the heart of the Coachella Valley, you have access to resort-style living and world-class amenities throughout Southern California.
Job Description:
Education:
Required: High school diploma, GED or higher level degree
Preferred: Some college or degree
Licensure/Certification:
Preferred: Non APC coding certificate
Experience:
Required : One (1) year in a clinic or hospital environment Preferred: Medical billing experience with extensive knowledge in Physician and clinical based billing
Job Objective:
Responsible for the review, update or entry of charges to the EPIC PB/HB billing system. Updates are based on LCD, NCCI and MUE edits contained within the EPIC system to reduce denials and produce clean claims.
Essential Responsibilities:
- Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
- Reviews assigned charge capture work queue daily including but not limited to: Filtering on priority based on high dollar and date of service, Matching E & M services to procedures, Validation of Bill area, Service provider and billing provider, Validation of New verses established patient, Validation of NDC numbers, proper quantity and administration code
- Updates or validates date of injury as indicated.
- Reviews documentation to ensure charge opportunities have not been missed.
- Enters comment as indicated on each encounter touched.
- Defers any encounter with a comment that requires coder or management review.
- Updates insurance as indicated including running a current verification.
- Maintains productivity standards per departmental policy.
- Maintains encounter turnaround time to at or below three days .
- Identifies and reports any system issues or provider trends affecting the charge capture process.
- Attends coder continuing education and departmental meetings as instructed.
- Enters and reconciles any manual batches as assigned.
- Demonstrates team support by completing training in other positions and assisting as needed.
Essential Skils:
- Prior EPIC experience a plus
- Ten key by touch and knowledge of all basic office equipment
- Experience with Internet applications, MS Word and Excel, CMS and payer portals or websites
- Strong data entry and keyboarding skills
- Research and analytical skills
- Positive interpersonal skills
- Knowledge of medical terminology, managed care, CPT/ICD10 coding and modifier association
- Detail oriented
- Ability to prioritize work queues and work somewhat independently
- Knowledge of Medicare and Commercial payer LCD’s and NCCI edits and resolution process
- Ability to communicate with all levels of management and providers
- Ability to review and interpret basic provider documentation to identify necessary additions, changes or voids
