Billing Specialist

Job Description

Reviews medical record documentation and billing sheets daily to ensure all professional charges are captured. Updates procedure and diagnostic codes as needed. Participates in revenue cycle processes to improve charge lag, ensure timely filing and enhance professional revenue for the Faculty Practice.

Duties and Responsibilities:

-Maintains a working knowledge of CPT and ICD-9/10CM coding principles, governmental regulations, protocols and third party requirements regarding coding and billing documentation.

-Codes charge tickets with appropriate CPT, ICD-9CM, ICD 10 and HCPCS codes for a multi-specialty group practice. Services include inpatient, outpatient, Emergency, and ambulatory surgery for both E & M encounters and procedures. Reviews and corrects, as needed, the charge tickets from various departments as to ensure the appropriate procedural or diagnostic codes are used. 

-Codes electronic charts for emergency and/or inpatient medical ward services and determines the accuracy of documentation required for chart completion. 

-Identify any areas for improvement in documentation as related to compliance and billing.   

-Maintains daily logs of coded work.
-Performs other related duties as assigned.

-Meets with physicians regarding documentation deficiencies for both electronic and paper charts.

-Assures that operative reports and other third party regulatory information are pertinent to coding requirements.

-Works with management and the billing vendor daily, on edit list and/or requests for additional information as to reduce denials and accounts receivable.

-Utilizes the Correct Coding Initiative (CCI) edits for accurate assigning of code and make use of the Local Coverage Determinations for medical necessity.

-Attends various meeting and seminars pertinent to one’s development.

-May train other coding specialists in coding update after seminars or conference.

-Reviews, modifies and recommends changes to policies and procedures to improve coding.

-Sends and follows up with coding queries to physicians regarding clarification of coding in operative reports, electronic for consults, coding sheets and charge tickets.

-Requires a level of understanding that is obtained or acquired through the completion of a High School Diploma.

-Knowledge of Medical Terminology, ICD-9CM, ICD- 10 and CPT 4 coding certification obtained by  completion of a certificate course with CPC / CCS-P credentials.

-At least six months coding.
-Certified Professional Coder. / AAPC

-Ability to use computer. Average dexterity and knowledge of software applications such as Microsoft, Excel, etc.

-Ability to work independently with minimal supervision at a high level of productivity.

-Ability to examine scanned documents, such as operative reports to determine accuracy of coding.

-Ability to prioritize own work and proceed with minimum supervision.

-Ability to maintain strictest confidentiality according to HIPAA regulations.

-Ability to work effectively with others as well as physicians.

-Be able to perform effectively with various commercial and hospital computer applications.

The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation.

EOE Minorities/Women/Disabled/Veterans

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