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SCHI Biller & Coder

Description

Job Description

HOW WE CARE FOR YOU:


At Rochester Regional Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community.

  • Pension Plan
  • Retirement Plan
  • Comprehensive Benefits Package
  • Tuition Reimbursement
  • Benefits Effective Date of Hire
  • Same Day Pay through Daily Pay

SUMMARY

The Biller & Coder reviews clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM and/or CPT codes for billing, internal and external reporting, research, and regulatory compliance. Under the direction of the Business Office Manager, accurately codes conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting and/or CPT Assistant. Demonstrates knowledge of reimbursement methodologies and applies to assigned charts in order to optimize reimbursement and/ or resolve regulatory edits. Submits bills to 3rd party payers and performs follow-up verification activities to assure collection of outstanding receivables. Reviews and resolves error reports associated with billing process, identify and report error patterns, and, when necessary, assists in design and implementation of workflow changes to reduce billing errors.

STATUS: Full time

LOCATION: Sands - Constellation Heart Institute, Greece

DEPARTMENT: Sands-Constellation Heart Institute

SCHEDULE: Monday-Friday Days (Hybrid)

CODING & DOCUMENTATION: Assign codes for diagnosis, treatments, procedures, and visits according to the appropriate outpatient encounter classification system. Review provider documentation to determine appropriate primary diagnosis and procedural and ambulatory office coding. Extract required information from source documentation and enter into billing system. Provide assistance and feedback to manager (and, at times, physicians) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process. Monitor electronic and paper billing for 100% Charge Review to assure timely and accurate claim submission. Correct errors and submits corrected claims when necessary.

CLAIMS & DENIALS: Utilize online insurance portals to access and reconcile claims. Monitor and reconcile aged receivables to avoid timely filing and other final denials. Accurately enter data, adjustments, and documentation of accounts. Assist in analysis of billing, coding, accounts receivable and other related data needs, as requested. Respond to patient inquiries in an accurate, timely, professional manner. Participates in new staff orientation. Apply understanding of insurance verification and authorization request process to ensure appropriate resolution to denial of claims to understand how best to resolve the issues.

PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

PAY RANGE: $18.25 - $23.31

The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran
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