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Professional Fee Coder 555437

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

Job Description

Professional Fee Coder

Under the direction of the Associate Director/Revenue Manager, the Analyst I Coder will be responsible for front-end billing functions from procedural & diagnosis coding and charge entry to contacting physicians for documentation tracking and updating.  Other duties may include assisting other Departments as needed/assigned. 

The Analyst I must be flexible and adept at juggling multiple tasks with competing priorities. Duties include researching billing/coding questions, working the billing work queues with various billing staff, training and auditing front and back-end billing processes and identifying opportunities for improvement.

Responsibilities (70% Coding, 30% Billing, Special Projects as assigned)

  • Assign and sequence  ICD-10/ICD-9 diagnosis codes, CPTs, and HCPCS codes based on review of inpatient and outpatient clinical documentation and diagnostic results
  • Code complex accounts from Professional Billing (PB) Claims Manager charge edits 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
  • Ensure and review diagnosis  and billing codes are consistent with physician notes
  • Ensure all applicable documentation necessary to meet insurance carrier billing guidelines
  • Keeps supervisor appropriately informed of any problem departments or physicians who need remedial training
  • Monitors billing edits and rejections to determine the reason, correct errors in Apex. Recommends operational changes if problem persist
  • Follow-up with provider and Revenue manager on non-billable charges and recommended course of action to address either compliance or missing charge errors
  • Work with internal and external coders,  Patient Financial Services, front and back end billing staff  and all other constituents to resolve and clear hospital billing work queues
  • Reviews APeX PB and HB RFI work queues on a daily basis and addresses inquiries from payors that require department review, and resolves any claim edits in these work queues to ensure timely billing.
  • Proactively reviews assigned work queues to reach out to faculty and ancillary providers for necessary documentation changes and updates.
  • Runs all necessary reports related to moving assigned charges along in their respective work queues.  For instance, missing charge reports, error reports, and other reports related to charge capture, error resolution and throughput                                                                                                                                       

Requirements:

  • Hold a valid CPC, RHIT, CCOC or CCA coding certification.
  • Demonstrate a year of coding and/or medical billing experience at a minimum.   We would prefer more years of experience but a year in a related field is the minimum.
  • Demonstrated ability to work in multiple computer systems with ease.
  • Must be a Certified Professional Coder in good standing with AAPC or AHIMA.
  • A fundamental understanding of coding (CPT and ICD-9) and documentation requirements (for both billing and compliance), and the billing submission process. 
  • AA degree or 6 months to 2 years of related work experience & education
  • Must be able to pass all classes related to the Center’s computer systems as well as related coding and billing applications. May include off-site billing systems from partner hospitals

Preferred:

  • Prior clinical experience
  • Strong computer skills; proficient in Excel, Word, PowerPoint
  • Strong analytical skills
  • Strong written and oral communications skills
  • Must be detail-oriented and have experience working with large data
  • Must have finance or accounting experience
  • Have great problem solving skills, independent and have a “can do attitude”

$40-$45 per hour             3 Month Assignment                Emeryville, CA 94608