Medical Billing Coder (Staff Specialist)

County of Orange • Orange County, CA

1d

About The Position

The Auditor-Controller Department is committed to serving Orange County by ensuring accountability over public spending, transparency of Taxpayer dollars, and engaging the public in government. We carry out our vision and mission by conducting the Public's business with the highest ethical and due diligence standards by supporting ethical and responsible financial decisions throughout the County. Health Care Agency Accounting is part of the Satellite Operations Division of the Auditor-Controller Department that is responsible for providing accounting support services to the Orange County Health Care Agency (HCA) Department. The Medical Billing Unit, within the HCA Accounting Division, ensures that HCA is billing in compliance with federal and state guidelines and all billing deadlines are met and revenue collection is not jeopardized. The Medical Billing Unit supports all the coding, billing and collections activities on behalf of HCA. Medical Billing Coder (Staff Specialist), under minimal supervision, reviews patient medical records to identify the principal diagnosis and all applicable secondary diagnoses and procedures in compliance with CPT and ICD-10 national coding guidelines; reviews coded patient records to determine whether they are complete and accurate; reviews Medicare, Medi-Cal and third party billings to ensure accuracy; interacts with clinical staff to clarify and validate patient medical records are accurately documented with patient diagnostic and procedural information; provides on-going training to clinical staff on various coding and documentation issues; and to do other duties as required. Staff Specialist positions may supervise office and/or technical staff; but the primary focus for this position is on the analysis of state and federal healthcare billing regulations to support the constant changes in the medical billing field.

Requirements

• Three (3) years of experience in medical records review, verifying procedure, or diagnosis coding.
• Extensive experience in implementing billing changes required by law, regulations or departmental policies and procedures.
• Maintaining applicable knowledge in Medicare, Medi-Cal, California Department of Health Care Services regulations, Federal/State billing regulations, and HIPAA.
• Conducting complex professional/technical research and analysis for assigned projects and to review the work of other staff.
• Reconciling or troubleshooting insurance issues related to billing.
• Preparing clear and concise financial and operational reports.
• Understanding of medical billing rules and regulations including, but not limited to, Medicare and Medi-Cal regulations.
• Knowledge of medical terminology including an understanding of ICD-10, CPT and HCPCS codes.
• Knowledge of general accounting principles and procedures.

Nice To Haves

• Certified Professional Coder (CPC) Certification
• Certified coder is a plus
• Experience in public sector is a plus
• Some leadership experience or an example of experience in leading a team during a project/assignment

Responsibilities

• Reviews patient medical records to identify the principal diagnosis and all applicable secondary diagnoses and procedures in compliance with CPT and ICD-10 national coding guidelines.
• Reviews coded patient records to determine whether they are complete and accurate.
• Reviews Medicare, Medi-Cal and third party billings to ensure accuracy.
• Interacts with clinical staff to clarify and validate patient medical records are accurately documented with patient diagnostic and procedural information.
• Provides on-going training to clinical staff on various coding and documentation issues.
• Analyzes state and federal healthcare billing regulations to support constant changes in the medical billing field.

Benefits

• Salary may be negotiable within the range listed above, based on position requirements and successful candidate's qualifications, subject to appropriate authorization.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed