Location

SAINT LOUIS, MO 63110

Scheduled Hours

40

Position Summary

This position is a shared role with the Adult and Pediatric Pain Management divisions. It includes but is not exclusive to the following: Maintains documentation on procedures and processes and assists staff and clinicians as needed, with daily operations including pre-certification. Assists with current and develops new billing processes. Works with the billing and coding teams to provide oversight and coordinate the communication and implementation for new or improved billing practices. Creates processes to reduce and recover lost revenue. Provides oversight and management of division WQs. Uses reporting to identify trends and changes for clinicians, pre-cert coordinators, and coders. Handles other special billing-related projects as needed to support the department and/or division. Participates on departmental level and divisional level project teams and handles various related projects on a routine or as needed basis.

Job Description

• Provides oversight to the internal billing related processes for Pain Medicine.
• Maintains current and concise working documentation of best practices for clinicians, pre-cert coordinators, and coders.
• Management of precertification and documentation for the Pediatric Pain clinics.
• Serves as liaison with EPIC, billing, coding, clinic staff, clinicians, and hospital teams to monitor and resolve billing discrepancies.
• Communicates system policies and helps educate staff to promote efficient flow of charge capture and billing for optimal reimbursement for the division.
• Advises department and divisional members on current system processes with recommendations for enhancement.
• Tests and coordinates new and changed processes prior to implementation.
• Provides training on new billing, documentation, or coding changes as needed.
• Oversees internal processes and monitors billing to reduce discrepancies with charge capture processes.
• Assists with audits of physician billed activities.
• Responsible for handling various projects, maintaining status of each and coordinating with others as needed.
• Serves on billing workgroup committees and teams as needed.
• Participates in department level and divisional level project teams as assigned and may assume leading roles as appropriate.
• Serves as the liaison with FPP I.S., PBS and BJH to coordinate and resolve issues including resolution of wrong patients billed, duplicate accounts, and billing related HIPAA issues.

Working Conditions:
Job Location/Working Conditions:

• Normal office environment.

Physical Effort:

• Typically sitting at desk or table.

Equipment:

• Office equipment.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time.

Required Qualifications

Education:

High school diploma or equivalent high school certification or combination of education and/or experience.

Certifications/Professional Licenses:

No specific certification/professional license is required for this position.

Work Experience:

Relevant Experience (5 Years)

Skills:

Not Applicable

Driver's License:

A driver's license is not required for this position.

More About This Job

Preferred Qualifications:

• Experience in medical billing and insurance.
• Working organizational and communication skills that require dealing with individuals at various levels of management.
• Understanding of Pain Medicine authorization, documentation, and billing processes.
• Working organizational and communication skills that require dealing with individuals at various levels of management.
• Excellent command and understanding of system programs and applications. ling with individuals at various levels of management.

Preferred Qualifications

Education:

No additional education unless stated elsewhere in the job posting.

Certifications/Professional Licenses:

No additional certification/professional licenses u