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Sobre esta vaga de Documentation and Reimbursement Specialist na Nationwide Children's Hospital

Nationwide Children's Hospital · Presencial · 3700 Corporate Drive, Columbus, OH

Overview:


 

Schedule: M-F (9:00am-5:00pm)

On-site until cleared to work hybrid (onsite 2 days per month after probationary period) - subject to change based on meetings


 

Job Description Summary:


 

Actively investigates claim denials, performs root cause analysis, and responds to inquiries regarding documentation, coding, and billing of professional services. Conducts claim reviews, assess charts, and collaborates to resolve issues and provide feedback.


 

Job Description:


 

Essential Functions:

  • Researches and responds to coding, documentation, compliance, and reimbursement inquiries.
  • Provides compliance and documentation education sessions to physicians and staff.
  • Clarifies ambiguous clinical data and provide feedback for improved documentation.
  • Resolves billing discrepancies and issues with insurance providers.
  • Collaborates with healthcare providers to gather necessary documentation for claims.
  • Updates billing software with relevant patient and insurance information.


Education Requirement:

  • As required by listed licensure and/or certification requirement.
  • Bachelor’s Degree, preferred.


Licensure Requirement:

(not specified)


Certifications:

  • Required to have one of the following certifications:
    1. Certified Coding Specialist Physician Based (CCS-P) Certification by the American Health Information Management Association (AHIMA).
    2. Certified Professional Coder (CPC) certification by the American Academy of Professional Coders.


Skills:

  • Proficiency with third party billing and documentation standards, particularly Evaluation and Management is essential.
  • Knowledge of medical terminology and proficiency with diagnosis and CPT4 coding required.
  • Excellent verbal and written communication skills.
  • Ability to maintain and establish strong working relationships with physicians, support staff, and external parties.
  • Able to work both as a team player and independently.
  • Strong analytical abilities.
  • Demonstrated aptitude for quantitative analysis and attention to detail.
  • Strong problem solving, collaboration, and interpersonal skills.
  • Able to balance multiple priorities and deadlines.
  • Proficiency with personal computers and related software.
  • Attention to patient confidentiality.


Experience:

  • Five years of experience in related field (physician billing experience), preferred.
  • One year of education or teaching related experience, required.


Physical Requirements:

OCCASIONALLY: Driving motor vehicles (work required) *additional testing may be required, Lifting / Carrying: 0-10 lbs, Standing, Walking

FREQUENTLY: Decision Making, Interpreting Data, Problem solving

CONTINUOUSLY: Audible speech, Computer skills, Flexing/extending of neck, Hand use: grasping, gripping, turning, Hearing acuity, Repetitive hand/arm use, Seeing – Far/near, Sitting


Additional Physical Requirements performed but not listed above:

(not specified)



 


 

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

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Sobre a Nationwide Children's Hospital

The moment you walk through our doors, you feel it. When you meet our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it. Welcome to Nationwide Children’s Hospital, Where Passion Meets Purpose . Here, Diversity, Equity and Inclusion are integrated into our core values and practices. We are passionate about building, sustaining and evolving an inclusive and equitable environment. We are seeking individuals who live these values and want to share their experiences and efforts in support of our collective mission. We’re 15,000 strong. And it takes every one of us to improve the lives of the kids we care for, and the kids around the world we

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