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Aultman Health Foundation

SENIOR CODER/BILLER

Aultman Health Foundation, East Canton, Ohio, United States, 44730

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SENIOR CODER/BILLER

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Aultman Health Foundation . Job Description: Aultman Medical Group/Professional-Senior Billing Specialist. Position Summary: The primary responsibility of this position is to review, analyze and/or assign ICD-10 Diagnosis and CPT Codes for all E & M, procedural and/or surgery codes for professional billing. Also, should be able to code for Professional Inpatient vs Observation status. Other responsibilities include revenue integrity functions including charge capture, timely charge entry, revenue improvement initiatives and compliant documentation review. Job function includes communicating with practice leaders, providers and CBO leadership on areas of concern or opportunity including open encounters and zero charges. The candidate may also be expected to assist in performing other administrative tasks as assigned and assisting other areas of the Revenue Cycle or Clinical divisions as necessary.

Primary Responsibilities

Proficiently assign ICD-10, HCPCS, CPT codes and modifiers to all assigned outpatient or inpatient records for all professional coding for AMG and hospital-based providers

Proficiently analyze ICD-10, HCPCS, CPT codes and modifiers to all assigned outpatient or inpatient records for all professional coding for AMG and hospital-based providers

Audit medical records for missing documentation, incomplete tasks, or unordered codes to prevent loss of revenue

Apply all NCD, LCD, MUE and CCI guidelines when coding or analyzing

Code to the highest specificity and educate the provider when an unspecified code is used but documentation supports a more specific code

Verify providers are capturing quality indicators and educate if missing

Maintain suitable knowledge of coding, compliance, governing bodies, and reimbursement policies according to the coding related to the specialty assigned to code

Responsible for open encounters and zero charge communication and tracking

Effective verbal and written communication with office staff, providers and AMG leadership

Meet/Exceed established productivity expectations

Meet/Exceed established quality expectations

Perform additional administrative tasks as assigned

Maintain attendance according to departmental standards

Meet/Exceed internal CEU hourly requirements

Complete safety evaluation, JCAHO education, Confidentiality, Information system usage, HIPAA corporate compliance education on an annual basis

Exhibit expected level of teamwork and respect

Desired Job Qualifications/Skill Sets

1-year minimum coding experience in a Physician office or Outpatient hospital setting mandatory. Abstraction of codes preferred

RHIA, RHIT, CCA, CCS or CPC required or preferred

Additional certifications helpful

Knowledge of accounts receivable goals and impacts

Ability to establish and organize daily work flow

Solid computer skills (Microsoft Office, encoder and other hospital software applications)

Ability to manage multiple demands from a variety of constituents

Seniority level Mid-Senior level

Employment type Full-time

Job function Engineering and Information Technology

Industries Hospitals and Health Care

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