Education

Specialized training in coding/abstracting procedures, anatomy and physiology and medical terminology obtained through seminars and college courses

Experience

One year of direct billing or collections experience required in a healthcare or insurance environment. Completion of medical billing and coding course and coding certification required. 1 year of CPT and ICD10 coding experience

Knowledge, Skills and Abilities

• Knowledge of collection procedures, laws, rules and regulations

• Skill in written and oral communications

• Skill in performing arithmetic calculations

Licensures, Certifications

Active AAPC certification required

Additional coding certifications applicable to physician practice billing preferred

Principal Duties and Responsibilities

• Works with front-desk staff and practice managers to ensure accurate patient registration in the practice management system

• Reviews provider documentation for auditing purposes related to billing and communicates with providers when there are errors, missing information, or other inaccuracies

• Reviews physician charges, adds modifiers, diagnoses, or other standard coding conventions to ensure accurate and timely billing, making corrections as necessary.

• Creates and submits clean claims for billing by reviewing and correcting claim errors in accordance with established policies and procedures

• Stays up to date on payer billing requirements, as well as CMS, CPT, and AMA regulations

• Reviews and works open encounter, encounter missing charges, and inpatient note reconciliation reports

• Communicates with patients when there are questions related to their billing and coding

• Functions as the practice liaison with the Billing Office and assists in educating the practice staff about efficient and compliant billing and registration practices

• Works with AR staff to resolve/appeal denials

• Works closely with Providers, offering assistance and education regarding correct CPT and ICD 10 coding as well as documentation requirements

• Manages time effectively and reviews a minimum of 12 charges sessions an hour

• Maintains coding certification through continuing education courses

Physical Requirements

• Ability to concentrate and pay close attention to detail

• Ability to sit for long periods of time

Working Conditions

• Normal office work environment

Conditions of Employment

N/A

All roles must demonstrate GBMC Values

GBMC Values

Value Description

Respect

I will treat everyone with courtesy. I will foster a healing environment.

• Treats others with fairness, kindness, and respect for personal dignity and privacy

• Listens and responds appropriately to others’ needs, feelings, and capabilities

Excellence

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

• Meets and/or exceeds customer expectations

• Actively pursues learning and self-development

• Pays attention to detail; follows through

Accountability

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

• Sets a positive, professional example for others

• Takes ownership of problems and does what is needed to solve them

• Appropriately plans and utilizes required resources for various job duties

• Reports to work regularly and on time

Teamwork

I will be engaged and collaborative. I will keep people informed.

• Works cooperatively and collaboratively with others for the success of the team

• Addresses and resolves conflict in a positive way

• Seeks out the ideas of others to reach the best solutions

• Acknowledges and celebrates the contribution of others

Ethical Behavior

I will always act with honesty and integrity. I will protect the patient.

• Demonstrates honesty, integrity and good judgment

• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

Results

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

• Embraces change and improvement in the work environment

• Continuously seeks to improve the quality of products/services

• Displays flexibility in dealing with new situations or obstacles

• Achieves results on time by focusing on priorities and manages time efficiently

Pay Range

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

Equal Employment Opportunity

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.