IHA Health Services Corp Certified Coding Specialist in Ann Arbor, Michigan
Facilitates appropriate billing for inpatient, outpatient, ER and other complex specialty services by verifying determination of services provided, patient diagnosis's via office and operative notes; enters correct charges into billing system; completes additional duties as required to ensure that billing and coding information is entered correctly and accurately. This position will be filled at the Oakland office.
**_ESSENTIAL JOB FUNCTIONS:
- Verifies the surgeon's determination of services provided and patient diagnoses via office and operative notes.
- Enters surgical charges in the billing system.
- Maintains complete knowledge and complies with all relevant insurance, CPT coding and diagnosis guidelines, disseminating info to staff and providers as necessary.
- Reviews quarterly provider audits, researching proper coding when necessary and working with coding and compliance as needed.
- Creates relationships with external organizations (i.e. St. Joe's and HVR) that allow for streamlining and quick resolution of billing matters for patients.
- Documents conversations with insurance companies and patients.
- Audits hospital reports for surgical procedures with office billing to ensure accuracy of billing to insurance companies.
- Audits FIN sheets to verify correct insurance and demographic information. Communicates with hospital when appropriate.
- Attends regularly scheduled meetings.
- Coordinates and follows through with special projects as assigned.
- Performs other duties as assigned.
- Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the IHA CARES mission and core values statement
- Must be able to work effectively as a member of the Business Services team.
- Successfully completes IHA's "The Customer" training and adheres to IHA's standard of promptly providing a high level of service and respect to internal or external customers.
- Maintains knowledge of and complies with IHA standards, policies and procedures, including IHA's Employee Handbook.
- Maintains complete knowledge of office services and in the use of all relevant office equipment, computer, and manual systems
- Maintains strict patient and employee confidentiality in compliance with IHA and HIPAA guidelines
- Serves as a role model, by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respects cultural differences.
- Uses resources efficiently.
- If applicable, responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.
Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.
EDUCATION: High School Diploma or GED
CREDENTIALS/LICENSURE: One of the following certifications: AAPC (CPC), PMIC (CMC), AHIMA (CCS-P)
MINIMUM EXPERIENCE: 2 years' surgical billing experience or other related background.
**_POSITION REQUIREMENTS (ABILITIES & SKILLS):
- Familiarity with billing and managed care department basic services and hours of operation to respond to customer requests accurately.
- Knowledge of medical, including surgical, terminology and procedures at the level needed to perform job responsibilities, including understanding of CPT and ICD-9/ICD-10 coding.
- Proficient/knowledgeable in the rules and regulations regarding insurance claim submission.
- Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, Microsoft Word, Excel, Outlook, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job.
- Excellent communication skills in both written and verbal forms, including proper phone etiquette.
- Ability to work collaboratively in a team-oriented environment; courteous and friendly demeanor.
- Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, patients, family members, insurance carriers, outside customers, vendors and couriers.
- Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations.
- Good organizational and time management skills to effectively juggle multiple priorities, time constraints and large volumes of work.
- Ability to exercise sound judgement and problem-solving skills, specifically as it relates to resolving billing and coding problems.
- Ability to handle patient and organizational information in a confidential manner.
- Ability to work under minimal supervision.
- Successful completion of IHA competency-based program within introductory and training period.
**_MINIMUM PHYSICAL EXPECTATIONS:
- Physical activity that often requires keyboarding, filing and phone work.
- Physical activity that often requires extensive time working on a computer.
- Physical activity that sometimes requires walking, standing, bending, stooping, reaching, and/or twisting.
- Physical activity that sometimes requires lifting, pushing and/or pulling under 20 lbs.
- Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus.
- Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.
- Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.
**_MINIMUM ENVIRONMENTAL EXPECTATIONS:
This job operates in a typical office environment and requires frequent change and significant interaction with people (many of whom are not familiar with the medical billing and reimbursement process) which can be stressful at times.
Category: Revenue Site Operations
Facility: IHA Administration
Department: Revenue Site Operations
Schedule: Full Time