Biller Coder

Clinica Romero•Los Angeles, CA

About The Position

Review medical records utilizing ICD-9 and ICD-10 and CPT coding conventions. Audits medical records to ensure specificity of diagnoses and procedures, and to ensure appropriate and optimal reimbursement from proper payer types.

Requirements

Highs School graduate or equivalent.
Knowledge of Medical Terminology and Anatomy & Physiology required
Knowledge of Confidentiality and rules regarding HIPAA and State and Federal governing release of medical information required
Minimum two (2) years of continuous, relevant ICD/CPT coding experience in an acute care facility within the last five (5) years is required
System oriented experience in use of computerized medical records abstracting, encoding and database systems
Observes CMOAR Appearance/Dress Standards.
Observe regulations on time card use and reporting.
Maintain attendance as a policy.
Maintain a clean and safe work area.
Observe general Safety/Employee Health policies and procedures.
Maintain a current annual health screening.
Observe CMOAR Appearance/Dress standards.
Maintain the privacy and confidentiality of both client and employee with regard to medical records.
Display clearly visible identification.
Treat all patients with respect and dignity and adheres’ to the Patient Bill of Rights.
Treats all employees with respect and dignity in accordance to non-discriminatory policy and procedure.
Treat all employees/clients in a courteous and professional manner.
Conduct only work related conversations when clients are waiting for service.
Do not discuss other staff members, policies, problems or medical care in public areas of clinic.

Nice To Haves

Associate Degree or two years of HIT college level coursework preferred
Knowledge of Title 22 medical record regulations preferred

Responsibilities

Analyze medical records and ensure all appropriate International Classification of Disease (ICD-9 & 10) and /or current Procedural Terminology (CPT) coding for billing of proper patient programs.
Enter and retrieve patient medical data from EPIC-Ochin System updating entries as necessary; audit medical record for accuracy and completeness, note deficiencies and refer for appropriate follow up and completion.
Consult with physicians and other personnel on coding practices and conventions to provide detailed coding information or gather additional documentation; maintain comprehensive records of all communications regarding suggested changes.
Research and initiate activity to resolve charges and coding issues, review difficult situations to determine the most appropriate codes.
Recognize potential for additional coding revenue and initiate the change in the EPIC-Ochin System.
Enter charges as recorded by back office or clinicians with in a timely manner; charges should be posted with 48 hours of patient visit.
Post payments to patient’s accounts within a timely period, review all denials and resubmit to correct payer.
All denials need to be investigated and follow up notes entered into the MIS System of any changes.
Review and track payments of all submitted billing, reconcile visits and payers records on a weekly basis.
Assist patients on program eligibility and on billing information.
Handles special projects and other duties as requested.