Job Description

Job Title: Billing Specialist

Location: New York, NY 10027

Shift: 9:00 AM - 5:00 PM Monday, Wednesday and Friday 3x8 hour (24 hours weekly)

Duration: 16 Weeks (Possible Extension)

Pay Range: $20/hr.

Job Summary

Responsible for office, out-patient, and inpatient physician coding. Provides education regarding documentation requirements to improve coding quality and ensure accurate and complete capture of revenue.

Duties and Responsibilities:

• Implements and manages outpatient and provider coding process for inpatient and outpatient physician services.

• Validates and determines appropriate coding levels by obtaining and reviewing clinical documentation.

• Compares and reviews charge tickets, both manually and system generated, to clinical documentation to ensure that all charges for procedures and related services have been accurately documented and captured.

• Ensures that documentation supports charges to prevent denials/underpayments and to ensure adherence to compliance standards.

• Follow-up on missing charge tickets and clinical documentation as appropriate.

• Develop educational materials and policies/procedures to assist providers with the new regulatory or payer policies.

• Identifies and assists with implementation of documentation and revenue enhancement opportunities.

• Collaborates with clinical staff to identify and implement appropriate documentation and coding modifications.

• Reviews and distributes coding related information to clinical staff, including CPT and ICD-9 code changes, medical necessity policies, coding /billing information regarding new procedures and pharmacy items.

• Develops educational material and policies and procedures to assist providers with understanding new regulatory or payer policies as they relate to coding changes.

• Assists in the development of fee schedule updates.

• Responsible for resolving any coding related errors, edits and denials that are identified by the physician practices or practice billing system.

• Consults and provides feedback with front line clinical staff, administrators and financial counselors to identify reimbursable indications for treatment.

• Continuously reviews revenue cycle with management team and supervisor.

• Participates in education programs to maintain up to date coding skills.

• Participates with the Compliance Department in random chart audits to ensure appropriate documentation, coding and billing.

• May prepare presentations for physician and staff practices as needed.

• May oversee the work of less experienced staff.Notifies patient of financial obligation for elective admissions and establishes payment arrangements according to financial policies prior to date of service.

Requirements:

Four years of experience in medical practice or outpatient coding.

Medical practice business office or patient accounts experience preferred.

Microsoft Office.

Knowledge of computer medical billing and/or electronic medical record systems such as Epic and IDX.

Knowledge of federal, state and payer specific regulations and policies is required • Excellent verbal and written communication and computer skills.

In depth knowledge of CPT4 and ICD9 coding and its applications.

Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors

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