Prebilling Coding Specialist - Revenue Cycle

Department:

10273 Enterprise Revenue Cycle - Government Billing Operations: IL HB

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

• Will be part of the Revenue Cycle team

• Full time with flexibility in the schedule.

• REMOTE

• Desired experience: HB Outpatient Coding Experience.

Pay Range

$24.85 - $37.30

Major Responsibilities:

• Edit and correct or coordinate the correction/review of edits generated on the 3M OCE/EAPG report.
• Based upon a daily review of the OCE/EAPG report, review alert against patient record to determine the appropriateness of corrections to patient's accounts.
• Make revisions with the utmost attention to accuracy to ensure correct claim generation.
• Demonstrate and maintain proficiency in what constitutes an appropriate correction to a patient's account, the appropriate party to make the correction, and the data which substantiates a correction.
• Document activities in a clean and concise manner in the Allegra system.
• Responsible for the filing, security, confidentiality, retention and storage of all government and private documents initiated in unit.
   

Combine accounts according to payer requirements when appropriate.

• Correctly identify when accounts are related or unrelated services by reviewing the clinical data contained in the patient's medical record.
• Review and combine accounts in a timely manner, specifically, prior to the generation of the claim.
• Demonstrate and maintain proficiency in properly combining accounts and/or charges according to payer policies and regulations.
• Contacts physicians and other health care professionals and hospital department representatives to obtain needed information required for the correct assignment of CPT-4/HCPCS, modifiers and charges for outpatient services.
   

Other duties as assigned by SRCO/Billing Management

• Responsible to read and understand all Advocate SRCO policies and departmental collections policies and procedures.
• Maintains knowledge of HIPAA regulations within the scope of the position and carry out job duties in a manner consistent with these regulations ensuring action is taken within guidelines set forth.
• Review and combine accounts in a timely manner, specifically, prior to the generation of the claim.
• Must attend and participate in and understand information presented at department meetings.
• Directs all questions or needs for clarification to management to ensure training needs are readily identified and addressed.
• Identifies and makes recommendations for process improvements.
• Responsible to read and understand all correspondence from Government Regulatory Agencies, Payer Updates, etc.
• Keeps abreast of all system requirements and changes. Achieves proficiency in all applicable functions of the patient accounting systems.
• Assists in completing ad hoc projects and related job activities as assigned to support department operations. During periods of high volume and/or impending deadlines, assignments may include assisting with patient accounting activities and functions typically performed by other SRCO positions.
  
  Maintains current knowledge of ICD-CM and CPT/HCPCS coding systems, as well as APCs and other outpatient reimbursement methodologies and maintains coding credential certification and maintains HIM and/or coding certification credential with AHIMA
• Attends internal and external educational seminars and inservices to satisfy continuing education requirements and maintain certification.
• Reviews the periodicals provided to remain abreast of changes that will affect coding and reimbursement methodologies.
• Participates in peer review activities to assess coding and abstracting accuracy.
  
  Responsible for personal and professional growth and development.
  • Seeks assignments and special projects to facilitate growth towards potential advancement.
  • Keeps abreast of current practices via literature, educational offerings, professional affiliations, etc.
  • Acquires and maintains knowledge of all insurance regulations, local, state, and federal legislation and regulatory agencies and activities which may affect SRCO operations.
     

Education/Experience Required:

• Certified Coding Specialist (CCS) credential for inpatient or outpatient coding positions or Certified Coding Specialist-Physician based (CCS