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Billing Analyst II 555461

Healthcare/Medical | Emeryville, CA | Full Time, Contract, Temporary, and Temp to Perm

Job Description

Billing Analyst II

The Analyst II, under the direction of their Revenue Manager and Associate Director, will provide support in areas of revenue operations related to coding, auditing, and training for their designated areas.  

Responsibilities include providing education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines. The Analyst II will perform in depth review of physician documentation and is responsible to present findings along with recommendations to the department on physician education.

The incumbent should be familiar with all applicable billing and coding regulations and be able to effectively communicate these regulations to all levels of faculty, management and staff.  

This position will also assign codes based on review of clinical charts, resolve coding issues based on denials, and identify areas of improvement.

Responsibilities:

  • Provide coding training and education to physicians, allied health providers (AHPs), and clinical staff
  • Maintain an advanced level of coding knowledge to support other coders on the team
  • Lead round table discussions with other coders and staff within the FPRMO
  • Provide analysis and review of coding to include research and interpretation of government regulations and payor billing requirements for new and existing services
  • Draft memos that provide input and explanation on coding documentation
  • Develop reference guides for faculty, AHPs, and staff to assist them in ensuring that they document all necessary elements within their notes
  • Partner with departmental resident/fellow education programs to develop presentations and materials to teach residents/fellows about proper documentation, how it impacts reimbursement, and how this will impact them when they become independently billable providers
  • Responsible for developing and maintaining the accuracy of educational information that is posted on internal websites
  • Research and respond to questions from physicians, AHPs, and staff in a timely manner
  • Research current trends in healthcare coding and compliance. Keep departments up to date on regulations and events that impact physician coding and billing
  • Review provider documentation to monitor coding accuracy and compliance with all CMS and payor guidelines
  • Perform specialized audits of patient medical records and provide documentation feedback to providers in a timely and professional manner
  • Identify issues related to billing denials and provide analysis to prevent future coding and billing issues
  • Partner with the Compliance Office in researching how to document for services new to providers 
  • Assign and sequence ICD-9, ICD-10, CPT, and HCPCS codes based on review of inpatient and outpatient clinical documentation and diagnostic results
  • Code complex accounts which requires advanced expertise in coding subject matters
  • Resolve Claims Manager and Epic Edits to ensure correct coding of services provided. This includes review of documentation for correct coding and E/M leveling, diagnosis coding, bundling issues, modifier usage, etc.
  • Audit the coding accuracy of outside coding vendors
  • Perform feedback and education sessions to the outsource vendor

Requirements:

  • Must be a Certified Professional Coder in good standing with AAPC, and maintain yearly credits to ensure certification.
  • Minimum of 5 years coding experience required
  • Must have experience working with CPT, ICD9, E/M Documentation Guidelines (1995/1997), CCI edits, Medicare LCDs, state and federal regulations as well as payor billing requirements.
  • Knowledge of medical terminology, anatomy and physiology
  • Strong analytical skills
  • Effective communication skills with physicians and clinical staff alike

Preferred:

  • Advanced Coding Certification(s)
  • Prior working knowledge of the EPIC (Apex) system
  • Academic medical center experience
  • Experience working directly with physicians, AHPs, and staff

$45-$50 per hour             3 Month Assignment                Emeryville, CA 94608