BILLING/CODING SPECIALIST (BCS)

 

JOB POSTING:  BILLING/CODING SPECIALIST (BCS)

Full –Time – Monday thru Friday

A coding specialist has knowledge of third-party billing procedures to include a range of payer systems. The candidate must have expertise in ICD-10 Coding and the current CPT procedures for a busy primary/specialty care practice. The Billing/Coding Specialists must have extensive knowledge of E&M Coding to conduct chart reviews utilizing the 1995 and 1997 E&M Guidelines. Telehealth/Telemedicine visits must be reviewed and followed up with all plans. Knowledge of Behavioral Health/Mental Health E & M Coding. The primary responsibility is to establish policy and procedures for "Best Practices", and to review and ensure practices are followed. The BCS will provide feedback to the Clinical Staff and Chief of Operations.

RESPONSIBILITY AND AUTHORITY

Essential Duties

• Ability to navigate with Intergy/Greenway Practice Management Systems
• Keen knowledge of E&M Codes for Primary Care/Specialty Practice, Licensed Clinical Social Workers (LCSW)
• Keep current on coding changes including modifiers for Telehealth/Telemedicine
• Ability to communicate effectively
• Understanding of Practice Management Systems-set-up for Best Practices
• Knowledge of NJ Medicaid; Medicaid Managed Care Plans; Medicare/Medicare Advantage Plans and all other third-party payers.
• Analyzes trends affecting Telehealth/Telemedicine Visits.
• Maximize revenues for all uninsured services
• Review and minimize Credit Balance Report – Uninsured Visits
• Interpretation of Practice Management Reports
• Ability to graph and explain trends of coding issues
• Review and coordinate findings related Coding with COO
• Review of Contracts with CFO/COO - all Payers based on Coding/Reimbursement
• Ability to sort through data for annual reports – UDS; Medicaid, Medicare and Managed Care Reports
• Attend Webinar/Seminars, audio conferences related to Coding
• Resourcefulness with questions about coding and E&M Procedures
• Training and updating Billing Staff on coding principles

Daily and Weekly Responsibilities

• Review on a weekly basis coding of Claim Reports
• Monitor all Telehealth/Telemedicine Claims for reimbursement
• Ensures that coding for ICD-10 and E&M Codes are system wide (Intergy) accurate
• Promotes the exchange of information between the Financial Counseling, Billing Department, Information Technology (IT) and CFO
• Support interdepartmental team building and timely resolution of coding/procedure code deficiencies.
• Performs other duties as assigned and required to maintain an efficient and effective workflow
• Review of Behavioral Health/Mental Health Coding

QUALIFICATIONS, KNOWLEDGE, SKILLS

Education:
High school diploma required.

Associate's degree with an additional 5–8-year relevant experience.

Bachelors’ degree:  Business Management/HealthCare Administration or Finance/Accounting preferred.

Experience:

Five – Eight years of experience in Primary Provider Practice to include:  Review of Coding for ICD-10 and E&M procedure codes and modifiers.

Knowledge of Level 1 HCPCS and Level 2 HCPCS

Review all payer contracts

Analyze data to support contract Negotiation

Review of Telehealth/Telemedicine coding and reimbursement

Ensure Health Care facility receives reimbursement for all procedures.

 

Language: 

English:    Bilingual Preferred

 

Training:

Working knowledge of Practice Management System (s).

Previous experience with Working in a Team Concept

Power Point- Visual Aid Presentation (s)

Certification:

Coding certification required
Recognized Certification from National Coding Organizations. (AAPC; AHIMA)

American Academy of Professional Coders/American Health Information Management Association

 

Special Skills:
Working Knowledge of Practice Management Billing Systems.

Greenway Intergy experience is highly valued.

Working knowledge of Microsoft Office products; Excel, Word, and Power Point.

Excellent analytical and interpretive skills.

Strong knowledge of ICD -10, CPT and HPCS coding.

Prior experience with a FQHC- "Federally Qualified Health Center".

 

 

 

 

The following statements reflect the general duties, responsibilities and competencies considered necessary to perform the principal functions of the job and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

Osborn Family Health Center is a Federally Qualified Health Center (FQHC), located in Camden, N.J, Equal Opportunity Employer.