Medical Billing/Coding Specialist

White Plains Hospital Center•White Plains, NY

33d

About The Position

The WPPA Medical Billing/Coding Specialist is responsible for coordinating, verifying, distributing and managing all billable services.

Requirements

High school diploma or GED required.
Knowledge of billing practices and clinical policies and procedures.
Knowledge of coding and clinic operating policies.
Minimum 1 year of billing experience in a healthcare organization.
Ability to understand and interpret policies and regulations
Ability to read and interpret medical charts for billing and coding purposes
Ability to examine documents for accuracy and completeness
Ability to communicate effectively both verbally and written and work with others
Ability to concentrate on fine details with constant interruptions
Perform multiple duties in a high volume area
Ability to deal professionally and efficiently with all levels of management and external constituencies
Self-starter, self-motivated and ability to work without supervision
Flexible, organized and able to set priorities
Demonstrates team work and adaptability.
Ability to perform computer work for extensive periods of time
Occasionally move and/or transport of 15 to 20 pounds
Requires movement about the department frequently throughout the day
Ability to remain in stationary position for extended periods of time
Ability to respond to frequent phone calls
May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital's SDS (Safety Data Sheet) data base and may be accessed through the hospital's Intranet site (Employee Tools/SDS Access). A copy of the SDS data base can also be found at the hospital switchboard, saved on a disc.

Nice To Haves

Some college preferred.
Coding certification or relevant coursework preferred.

Responsibilities

Understands and adheres to the WPH Performance Standards, Policies and Behaviors
Fulfills responsibilities as assigned which may include a. Coordinating with clerical/clinical staff to obtain insurance/charge information for all patients b. Accurately assigns CPT, ICD-9/ICD-10, HCPCS codes based on documentation presented c. Verifying and completing charge information in database and generates bills d. Processing and distributing copies of billings according to office policies e. Maintaining required billing records, reports, files, etc. f. Responding to tasks in a timely manner to facilitate resolution of any claim related issues
Follows New York State requirements for the appropriate and timely submission of all coding, including worker's compensation and/or no fault visits, and daily reviews of pending charges for all providers
Works collaboratively and maintains effective communication with internal and external stakeholders
Works independently to prioritize, organize, and manage a daily assignment within the normal work period
Recognizes problem situations, sets priorities appropriately, offers feasible solutions, initiates appropriate actions
Fulfills organizational responsibilities as assigned including respecting/promoting patient rights; responding appropriately to emergencies; communicates concerns/ problems relating to patients and/or staff with immediate supervisor
Utilizes appropriate steps in the decision making process to include recognition and priority setting relating to patient care and practice based issues
Attends in-services as required/requested
Cross-trains as back up to other business office positions as requested
Communicates all issues and concerns to appropriate parties effectively in an effort to facilitate resolution and maintain compliance with related laws and regulations
Demonstrates understanding of health insurance policy results in terms of proper claim adjudication
Demonstrates aptitude in how to interpret the coding guidelines for CPT, ICD, HCPCS
Demonstrates proficiency in computer software including Meditech, EPIC, Microsoft Office Suite
Maintains ongoing expertise in relevant coding chapters and reviews these annually for changes, new and deleted codes
Adheres to WPH infection control standards including, but not limited to hand hygiene
Completes annual mandatory requirements including Occupational Health Requirements
Performs all other related duties as assigned.