Here at Carolina Pines Regional Medical Center, we are committed to our employees, because when we join together, our patients are cared for in a high-quality and compassionate way. If you're looking for a company with a wide variety of career choices and a culture focused on excellent patient care, then you've come to the right place!

Under the general supervision of the Clinic Operation Manger the position will be responsible for management of the billing procedures to ensure accuracy and efficiency. Will inform manager of documentation issues and person responsible for duplicate documentation errors.  Will provide documentation education to staff in cooperation with the manager. Will conduct special request audits, patient request audits and government audits. Will perform other duties as assigned.

To perform this job, an individual must perform each essential function satisfactorily with or without reasonable accommodation. 

1.     Overall review of each charge per protocols to ensure accuracy and efficiency.

2.     Review of department’s policy and procedures for charging and billing.

3.     Post all charges in a timely manner using the appropriate modifiers and codes per coding guidelines.

4.     Conduct audits for special requests, patient request and insurance defense audits.

5.     Review all accounts daily and verify completion.

6.     Take appropriate adjustments.

7.     Apply patient payments and discounts in Athena.

8.     Resolve necessary edits daily.

9.     Auditing injection/infusion charges to ensure injection hierarchy is maintained.

10.  Review and work task list as assigned.  Takes corrective action and/or bill accounts as per financial policy and procedure.

11.  Follows up on outstanding claims/denial through task list assigned.

12.  Maintains confidentiality of patient information. 

13.  Responsible for verifying patient/insurance refunds.  Files proper paperwork to reimburse payment to patient or insurance company in a timely manner.

14.  Maintains current reference material for all ICD-10, CPT, & HPCS codes and has working knowledge coding guidelines for maximum reimbursement.

15.  Process payments as needed.

16.  Generate reports for charge integrity reconciliation

17.  Troubleshoots all bill discrepancies timely.

18.  Cleans and sanitizes telephone and desk in assigned area.

19.  Other duties as assigned.

Qualifications:  High School Diploma or Equivalent, required. Coding Certification preferred.

Experience:   Experience in physician practice billing and CPT, ICD-9-CM preferred.