Billing Specialist

Description

Certified Coding Specialist

Job Title: Dallas IVF: Certified Coding Specialist
Department: Billing / Admin Clinical                                                                
Position Summary:
Under the direction of the Clinical Operations Supervisor, performs various duties to accurately interpret and bill physician charges for physician services. Entering into the Billing System appropriate CPT and ICD-9 codes bills charges.
 
Minimum Qualifications:
 
Education and Experience

• High school diploma or GED completion is required.
• Certified Professional Coder with a minimum of two years’ experience with CPT/ICD-9/ICD-10 coding of physician services preferred.
• Good working knowledge of medical terminology and anatomy required.

Job Knowledge

• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Excellent interpersonal skills and a basic understanding of team workflow management concepts.
• Ability to gather and interpret clinical data.
• Ability to work independently in a fast-paced environment.

Essential Duties

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services.
• Enters appropriate data into the Billing System(s) by selecting the appropriate codes, diagnosis, modifiers, and times of start and stop of the case, anesthesiologist, and surgeon information to complete the charge process.
• Contacts physicians through management regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients.
• Monitors and follows up to ensure all services that can be billed are captured and coded for billing.
• Responsible for ensuring the batch processes for all coded charges.
• Utilizes batch-logging systems to comply with internal audit standards.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for CHS physicians' services.
• Works in coordination with other members of the Physicians' Billing Office as necessary.
• Meets and exceeds short and long term goals as established for the department.
• Performs duties and job functions in accordance with the policies and procedures established for the department.
• Reports to work, meetings and professional obligations on time.
• Participates in administrative staff meetings and attends other meetings and seminars.
• Assists in evaluation of reports, decisions, and results of department in relation to established goals.
• Recommends new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed.
• Serves as a member of the Clinical Operations Department. Performs duties necessary to ensure the team's projects/goals are completed.
• Takes ownership of special projects, research data and follow through with detailed action plans.
• Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.
• Performs other related duties as required and assigned.
• Adheres to Corporate, Department and HR policies and procedures.

Physical Requirements

• Employee is required to have visual and auditory acuity necessary for communications with other employees and/or customers to meet business needs of DIVF.  
• Employee must be able to see written documentation and be able to speak and hear for communication with employees/customers.   
• Ability to use a wide array of office equipment including, but not limited to a PC, copier, fax, multi-line telephone, etc.  
• Employee is exposed to general indoor working conditions and may on occasion require light lifting or no greater than 20 pounds and some offsite travel.

Qualifications

• High school diploma or GED completion is required.
• Certified Professional Coder with a minimum of two years’ experience with CPT/ICD-9/ICD-10 coding of physician services preferred.
• Good working knowledge of medical terminology and anatomy required.