Billing and Coding Support

Job Description

Job Description

Summary :

This position is responsible for reviewing provider charges and insurance, making corrections as needed, adding modifiers, and processing provider charges from the Holding Tank, tasking providers with clarifying questions or notification of un-submitted charges, manual entry of hospital and nursing home charges, and providing support to the billing company as needed with A / R follow-up.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

• Understand functions within the Practice Management system of Nextgen including batch posting, holding tank, charge screen, and work log.
• Collect hospital charges from Women’s Care providers on a routine basis in addition to reviewing weekly hospital surgery schedules and daily census in order to ensure timely submission of charges. Download all pertinent information including Patient H&P, Face Sheet, and Discharge info from the hospital’s EMR system, review documentation and using most recent Coding Books assign CPT codes, ICD-10 codes, and modifiers. Enter charges into Nextgen system when the required documentation is available and the patient has been discharged.  Utilize provider as a resource for any questions.

Maintain monthly lists of NSTs, Surgeries, and Deliveries

Review and Process Medical, Behavioral Health, and Telehealth charges from the Holding Tank. Review Insurance, Location, and Provider related information. Review ICD-10 and CPT codes.  Add appropriate modifiers, global codes, zero out charges as indicated in Standard Operating Procedure, change Place of Service when needed, and process Sliding Fee out of the charge screen and calculate and calculate / apply Prompt Pay Discounts. Hold processing as needed such as when to perform this job successfully, an individual must be able to assist in advancing Grace Health’s mission and to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SKILLS :

Familiar with Electronic Medical Record

EDUCATION and / or EXPERIENCE :

Must have completed high school.  Medical Office experiences a plus.

Must have a minimum of 2 years medical office billing experience.

WORK ENVIRONMENT :

Grace Health is a faith-based, federally qualified community health center (FQHC). We provide primary health services to underserved, underinsured, and uninsured individuals in the southeastern Kentucky region. Our mission is “to show the love and share the truth of Jesus Christ to southeastern Kentucky, thorough access to compassionate, high quality, primary health care for the whole person” regardless of ability to pay.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

OTHER ESSENTIAL DUTIES and RESPONSIBILITIES :

Team members will participate in Grace Health's advocacy program.

GENERAL DUTIES :

QUALIFICATION REQUIREMENTS :

To perform this job successfully, an individual must be able to assist in advancing Grace Health’s mission and to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SKILLS :

EDUCATION and / or EXPERIENCE :

Must have completed high school.  Medical Office experiences a plus.

BENEFITS :

Wellness program

Grace Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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