To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Responsible for ensuring all charges from the Diagnostic Radiology have been appropriately prepared for posting on the patient's account. Working closely with the Business Services manager, this individual is accountable for the reconciliation of charge code exceptions on a daily basis. In addition this position is responsible for monitoring and tracking all charges that have been released in the EMR (EPIC) for Billing and Coding. Investigates , reconciles and follows up on all accounts being held in Work queues as Billing errors. .Any variances are identified and reconciled in collaboration with Patient Financial Services , Revenue and Reimbursement and the Hospital Billing Office. Individual works directly with Revenue and Reimbursement for updating , initiating and auditing Revenue codes to ensure the appropriate CPT code has been assigned. . The Revenue and Coding analyst works with Imaging manages and supervisors in reconciling and tracking Billing and Coding Edits and Denials for Imaging procedures ensuring optimal reimbursement. Works collaboratively with the Professional Billing leadership and coding team (s) to ensure the codes match for the Imaging procedure performed and the professional intepretation of the procedure. Understands and follows up on all Imaging procedures that have been assigned Modifiers that may impact reimbursement. Reviews and handles interventional procedures performed within Diagnostic Radiology, IE: Breast Imaging procedures, Spine Injections, aspirations etc. to ensure all codes have been appropriately assigned for optimum reimbursement under the direction of the Lead.
- 1. Reconciles and monitors all charge adjustments.
- 1.1 1.1 Reviews Error templates from Imaging Managers
- 2. Identifies lates charges as identified in EPIC.
- 2.1 2.1 Identifies charges posting late to patient accounts
- 3. Ensures Imaging Exam codes in EPIC have appropriate CPT and EAP Codes
- 3.1 3.1 Reviews requests for Imaging Exam Codes with section Manager
- 4. Reviews exam charge edits or denials as identified by billing, coding and/or revenue reimbursement.
- 4.1 4.1 Provides feedback and expertise to questions related to charge edits, denials or audits as identifed
- 5. Reviews and documents Imaging charges released from EPIC Daily
- 5.1 5.1 Prepares and runs Revenue and Usage reports from EPIC
- 6. Ensures all Work queues have been processed
- 6.1 6.1 Reviews daily all Billing, Coding, Charge capture work queues
- 7. Performs quarterly audits as identified by the Lead
- 7.1 7.1 Works with Lead and Business Mgr to run quarterly audits
Must be a Certified Professional Coder with an Associate degree in Secretarial Science, Business or Healthcare related field required or equal number of years experience in a Healthcare / Third party payer environment.
Minimum 3 to 5 years experience in Medical Coding with an understanding of Third Party payor requirements, Medicare Medical Necessity, LCDs and ABNs.
Excellent telephone communications, interpersonal, coordination and organizational skills. Ability to read computer screens, forms, and other documents and follow written and oral instructions. Moderate keyboarding skills. Ability to work in a fast-paced, changing environment. Ability to respond to unpredictable, changing situations and needs (including clinical crises in the section and otherwise stressful situations and interactions) with professionalism, good judgment and ALWAYS excellent customer relation skills. Prior customer service coordination or clinical experience necessary. Excellent communication and people skills. Individual must be articulate and confident in both oral and written communications . Ability to remain calm and professional in high stress situations.
Primarily sedentary work sitting within typical office setting without exposure to adverse environmental conditions. Requires occasional ability to lift, push and pull objects such as files and office supplies up to 30 pounds and/or continuously up to 10 pounds; and occasional moving about on foot to accomplish tasks, walking long distances or moving from one work site to another. Continuous use of telephones requiring ability to hear and speak to convey detailed or important instructions accurately, loudly or quickly; and continuous use of computer and other office equipment requiring fingering and excellent keyboarding skills.