Hiring Range = $16.00 - 17.90\hour
This position works under the supervision of the Reimbursement Supervisor. The Coder and Biller I provides coding and insurance support to the Billing Department. Demonstrates understanding of health insurance, Medicare, Medicaid and the SFHC discount program to ensure the integrity of claims and to assist patients as needed. Screen patients and assist the uninsured with enrolling in applicable discount/insurance programs Meet requirements and competencies to be designated as a “certified application counselor or Navigator” under CMS/HRSA definition. Meet performance standards of Presumptive Eligibility Specialist to enroll qualified pregnant women and children in Kansas Medicaid. At times during the year there may be additional hours, prior approval for these hours will need to be obtained from the Reimbursement Supervisor. Participates in staff meetings, and abides by general policies and rules of conduct as outlined in the employee handbook and office policy and procedures. In accordance with HIPAA regulations, this position requires full access to Protected Health Information (PHI). Such disclosure is necessary to perform the requirements of the job. Confidentiality of PHI must be maintained.
Salina Family Healthcare Center (SFHC) is dedicated to providing high-quality, patient-centered care and creates a culture of continuous quality improvement. Each employee is expected to work collaboratively within the department and with other departments to ensure patients receive quality care. Employees are expected to conduct themselves in a professional manner that leaves both the employee and SFHC in a positive light. Maintaining a positive work atmosphere by acting and communicating in a cordial manner with customers, clients, co-workers, and management is essential.
The position requires full range of body motion, hearing and eyesight in order to perform duties of the position. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. While performing the duties of this position, the employee must be able to sit or stand for long periods of time (6-8 hours). Interaction with others is frequent and can often be disruptive so the ability to multi task is important. Employee must have hand/eye coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment. Employee must be able to write, speak, and hear. Employee must be able to read small print both on paper and on a computer screen for long periods of time. This position requires occasional lifting/carrying items of up to 30 pounds, bending, stooping, and stretching. This is a medical office environment involving frequent contact with staff. There may also be exposure to airborne and bloodborne pathogens, and hazardous materials. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Timely review of patient charges prior to creating claim for accuracy and completeness; obtain/correct any missing information.
2. Accurately review office visits for appropriate diagnosis (ICD10), procedures (CPT) and HCPCS codes prior to billing claims.
3. Demonstrates and maintains working knowledge of third party payer regulations and claim policies to include FQHC, Medicare and Medicaid too accurately submit claims and assist patients as needed.
4. Assist with reducing claim denials.
5. Monitor, identify, research and resolve outstanding unpaid claims.
6. Accurately screen and review screenings to ensure the Discount Program integrity, updating appropriate practice management systems accurately & timely.
7. Meet requirements and competencies to be designated as a “certified application counselor or Navigator” under CMS/HRSA definition.
8. Obtain Presumptive Eligibility Specialist designation and meet performance standards as outlined by KDHE-DHCF in order to enroll our pregnant women and children that are eligible in Kansas Medicaid.
9. Attend meetings as required (Joint Staff, Division, etc.).
10. Perform other duties as assigned.
1. Ability to establish and maintain effective working relationships with staff, patients and the public.
2. Enthusiasm for working as a member of a team in a rapidly changing environment.
3. Knowledge of HIPAA privacy rules and regulations.
4. Excellent interpersonal, mathematical, verbal and written communication skills.
5. Ability to complete work that is reasonably void of errors and high in accuracy.
6. Excellent customer service skills and ability to effectively and respectfully interact with unsatisfied patients and coworkers.
7. Must be able to document in a neat, legible manner and be able to spell medical terminology correctly.
8. Knowledge and experience with Microsoft Work, Excel Spreadsheets, Windows, databases, graphs and the ability to write reports and correspondence by using proficient grammar, spelling and punctuation.
9. Ability to manage multiple tasks, work under pressure, and prioritize workload, while maintaining work accuracy.
10. Effective and efficient time management.
11. Excellent organizational skills.
12. Ability to follow written policies and procedures.
13. Ability to work independently and use good judgment.
14. Knowledge of standard office machines including copier, fax, multi-line phones, printers, scanners, etc.
Education and Experience
1. High school diploma required;
2. Certified Professional Coder (CPC) OR equivalent of two years coding and insurance in a medical related field;
3. Excellent organization, prioritization, and follow-up skills required;
4. Strong attention to detail;
5. Confidentiality required;
6. Ability to handle deadlines and to work under pressure with multiple interruptions;
7. Requires knowledge of ICD10, CPT and HCPCS Coding;
8. Social and cultural sensitivity appropriate to ethnically and economically diverse patient and employee-base.
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