Billing Auditor II
Responsible for accurately coding, reviewing, and posting all charges from fee tickets, hospital cards, medical records, and operation notes. Responsible for verifying all charges have correct diagnosis to justify procedure. Responsible for making sure all procedures performed are billed out to insurance companies or patients within 48 hours of being performed in the office or nursing home and within 72 hours of being done in the hospital. Responsible for making sure all procedures are properly coded and modifiers used when medically necessary to justify procedure for payment. Ensures that all documentation is present before procedures are billed.Accurately and efficiently fulfilling these duties has a major impact on appropriate reimbursement for procedures performed. Must keep abreast of scheduled workload at all times and be able to set priorities. Productivity is measured on a daily, weekly, and monthly basis. Accountability is measured through performance appraisals, quality of work, productivity, direct observation, and peer review.Other duties include special projects, as assigned by department manager.
EducationHigh school graduate or equivalent and successful completion of coding certification exam administered by AHIMA or AAPC (CCS/CPC), or Associates Degree in Health Information Management (RHIT).Licensure/CertificationSuccessful completion of coding certification exam administered by AHIMA or AAPC (CCS/CPC) required.ExperienceMinimum of two years in hospital/physician office required, to include knowledge of billing, Medicare/Medicaid/ Third-Party insurance processes, with a minimum of one year coding experience in ICD-9 and CPT required. Credentials (RHIA, RHIT, CCS, or CPC) may be substituted for previous coding experience.Knowledge, Skills and AbilitiesGood communication skills and excellent customer service skills required in order to communicate with variety of customers (physicians, patients, insurance companies, hospital staff, other staff members) in a professional manner at all times.Must be able to prioritize multiple tasks and responsibilities while meeting deadlines and maintaining a high quality of work.Basic knowledge of computer mainframe/PC experience and general medical office procedures required in order to assist other workers when needed and update patient information.Must have the ability to interpret and understand medical records, operation notes, and correspondence from physicians.Must have thorough working knowledge of official coding and billing guidelines, adhere to these guidelines and ensure that coding and billing practices for services are according to the laws, regulations, and guidelines that govern compliance.Physical DemandsWill be required to sit and/or stand for long periods of time, with high level of mental/visual concentrations. Must have good manual dexterity to use tele****
Department8910 - University Physicians CBO
Shift8:00 am - 5:00 pm