The purpose of Minidoka Memorial Hospital is to provide and promote high-quality, compassionate, primary health care services and health education to residents of, and visitors to, the Mini-Cassia region. We provide excellent benefits and small town environment.


DEFINITION

Coding and Billing Specialist is responsible for accurate coding and billing submissions for a multi-specialty office following ICD 10 Classification of Diseases and AMA Current Procedural Terminology guidelines. Ensures that records are coded in an accurate and timely manner. Review provider documentation and performs data entry of diagnosis codes and charges. Analyze and resolve billing and/or EMR system issues to obtain maximum reimbursement. Assists in reviewing billing and coding tasks for claim denial resolution. Maintain pleasant and professional working environment.

JOB ESSENTIALS

• Demonstrated competence in coding and the appropriate application of official coding and billing guidelines to specific coding situations.
• Accurately capture all CPT, HCPCS and ICD10 codes to the highest specificity while adhering to payor and federal guidelines
• Ensures that records are coded within 72 hours of discharge, excluding weekends and holidays.
• Submits claims and/or encounters for clinical services providers.
• Submits claim corrections as needed in a timely and efficient manner.
• Reviews physician documentation and other clinical documentation to ensure that said documentation supports all assigned codes.
• Contacts responsible documenting provider in a timely, professional, tactful manner, if corrections to documentation need to be made.
• Coder’s diagnoses and procedures on clinical summary agree with physician’s preference 100% of the time.
• Utilizes computerized coding/abstracting equipment.
• Meets quality standards of having 95% of principal diagnoses and procedures appropriately and/or correctly coded.
• Maintains 99% rate of information correctly abstracted.
• Notifies director whenever work is more than 3 days behind work deadline.
• Assists the director with state requirements and reports.
• Ensures data quality and optimum reimbursement allowable under the federal and state payment systems.
• Maintains regulatory requirements, including all federal, state, local regulations and accrediting organization standards
• Performs performance improvement functions through data collection and documentation review.
• Provide Feedback to providers on documentation needs/requirements
• Participates in accurate data collection, analysis, evaluation, problem solving and recommendations of process improvements, including productivity and special projects.
• Review of charges and acceptance for billing as assigned.
• Updating billing software with rate changes.
• Must be familiar with all medical record and coding/billing requirements.
• Maintains a good working relationship within the department, other departments and medical staff.
• Supports and maintains a culture of safety and quality.
• Willing to accept additional assignments.
• Adheres to dress code, appearance is neat and clean.
• Completes annual education requirements.
• Maintains patient confidentiality at all times.
• Actively participates in performance improvement and continuous quality improvement (CQI) activities.
• Complies with all organizational policies regarding ethical business practices.
• Communicates the mission, ethics and goals of the hospital, as well as the focus statement of the department.

In addition to these general duties, an individual employer may request that you perform other duties that fit with your training and background experience or provide further training for new duties.

Minimum Requirements

• High School graduate or equivalent.
• Knowledge of diagnoses/procedures in accordance with ICD-10-CM/CPT coding principles.
• Associate Degree in related field, Medical Coding Certification or Diploma ( ie: CPC via AAPC/AHIMA or equivalent)
• Ability to multi-task/work with deadlines.
• Working knowledge of various insurance payor guidelines, ie-modifier usage, timely filing
• Knowledge of billing practices
• A minimum of two to three years of experience in a medical office setting.
• Knowledge of EMR required.
• Able to communicate effectively in English, both verbally and in writing.

Physical Requirements

Perceive the nature of sounds by the ear, express or exchange ideas by means of spoken word, perceive characteristics of objects through the eyes, extend arms and hands in any direction, seize, hold, grasp, turn, or otherwise work with hands, pick, pinch, or otherwise work with fingers, perceive such attributes of objects or materials as size, shape, temperature, or texture; and stoop, kneel crouch, and crawl. Must be able to lift 25 pounds maximum with frequent lifting, carrying, pushing, and pulling of objects weighing up to 10 pounds. Continuous sitting. Must be able to identify, match, and distinguish colors.