Job Description
Overview
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.Under the direction of the Director of Laboratory Medicine, performs a variety of billing and coding related functions. Responsible for the clearing of claim edits that fall into billing work queues specific to the laboratory. Researches and corrects errors or missing information from each account to ensure proper and timely payment. Duties include prior authorization of Tumor Profiling and Molecular tests to support physician orders. Actions must consistently exemplify all HRO, CHAMP, Service Excellence and employee handbook guidelines.
EEO/AA/Disability/Veteran
Responsibilities
- 1. Monitors and clears claim edits from billing work queues.
- 1.1 Using CPT-4 and ICD9 & ICD10 coding systems assign codes for ambulatory encounters in accordance with national and departmental guidelines
- 2. Assists with the monthly billing audits
- 2.1 Keeps statistics of which physician offices or clinics are chronically submitting specimens with missing information and reports this information to the Billing Coordinator
- 3. Provides billing assistance to the Tumor Profiling Laboratory
- 3.1 Determine patient insurance for pre-certification status. Initiate / review ABNs on all non-Medicare and inpatient cases
- 4. Provides a high level of customer service and professionalism in all interactions with clients and YNHH staff.
- 4.1 Maintains a positive relationship with co-workers, supervisors and all clients at all times.
- 5. Performs other related duties as required or directed.
Qualifications
EDUCATION
High school degree required, AS or BS degree in healthcare or business related field preferred. Additional training in ICD9, ICD10, CPT4 and evaluation and management coding. Knowledge of medical terminology, anatomy and physiology required. Any certified coding certifications preferred but not required.
EXPERIENCE
1-3 years of experience working in a healthcare setting. Clinical laboratory or medical billing experienced highly preferred.
LICENSURE
CPC / CPC-H / CCS-P preferred
SPECIAL SKILLS
Knowledge of medical terminology required.
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