Schedules applicable patient appointments; obtains and ensures a complete physician order is in place prior to scheduled tests; screens for medical necessity based utilizing current LCD and NCDs/medical necessity software; ensures any applicable procedure authorization is obtained and noted in the applicable systems prior to the scheduled procedure; facilitates any needed patient financial counseling; performs timely review and verification of coding information for department and accurate billing as directed by the manager. Inputs all charges into the appropriate system in a timely manner; implements and performs all corrections of coding and billing information according to regulations and guidelines established by policy. Assures compliance with regulatory requirements regarding billing processes and optimizes the revenue cycle through ongoing monitoring and review of the processes, systems, and compliance audit outcomes. Active participant in department quality improvement initiatives and activities.

Education and Training

• High School Diploma or equivalent required. Associate/Technical degree in business/healthcare related subject preferred.

Experience

• Two (2) years experience in a medical office practice with one (1) year of medical services billing/registration/coding, preferably in a hospital setting.

Other Skills, Competencies and Qualifications

• General knowledge of CPT and ICD-10 coding guidelines.
• General knowledge of the revenue cycle compliance/auditing processes.
• Ability to pass medical terminology test administered by HR.
• PC Software experience and knowledge (i.e. Word, Excel, database.e management).
• Certification as an Insurance and Coding Specialist preferred.