- Administrative Office
- Portland, OR, USA
- Full Time
Medical/Vision, Dental/Orthodontia, 401(k), Employer Paid Long Term Disability Insurance, Employer Paid Life & Accidental Death & Dismemberment Insurance, Voluntary Short Term Disability Insurance, Voluntary Life Insurance, Voluntary Long Term Care, Flexible Spending Medical, Dependent Care, & Transportation Accounts, Paid Time Off & Holidays, Life Balance, Employee Assistance Program
Imagine waking up excited to come to work, at a place where you have the opportunity to serve others. You make a difference - and have fun doing it! People are drawn to Women's Healthcare Associates because of our values-driven culture.
The Senior Billing and Coding Specialist reviews claims data to ensure the assigned procedural and diagnosis codes meet required legal and insurance rules.
*This is a 40 hr/week position (Monday-Friday).
DUTIES
- Runs daily schedules to cross-reference that charges are entered into the EMR.
- Audits each charge to ensure billing codes are accurate prior to claims submission.
- Runs weekly reports to capture missing charges. Researches missing charges and enters the change when appropriate.
- Runs monthly reports to track billing for pregnancy services. Verifies delivery, antepartum and postpartum care are billed accurately and makes corrections when needed.
- Verifies hospital services within the hospital medical records system.
- Enters ancillary services such as central lab, DEXA, mammograms and ultrasound.
- Supports A/R department by analyzing and problem solving complex coding errors.
- Adds correspondence notes whenever a claim has been changed or reviewed.
- Acts as a liaison between business office, clinicians and other staff in communicating information regarding patients' services, insurance guidelines and billing.
- Educates clinicians and staff regarding coding questions.
- Provides feedback to clinicians if there are trends of coding errors.
- Bills all services in a timely manner.
- Stays up to date with coding changes, including but not limited to CPT, ICD-9, ICD-10 and insurance changes.
- Writes up adjustments as needed.
- Assists with training new staff and mentoring staff members as requested.
- Works with Financial Counselors to assure correct CPT and diagnosis codes are being put on prior authorizations for surgeries.
- Takes responsibility for and demonstrates safe work practices.
- Maintains regular and predictable attendance.
- Maintains WHA confidentiality standards.
- Attends WHA meetings, department meetings and other group meetings as assigned.
- Models The Values Statement and The Patient Experience of WHA.
QUALIFICATIONS
- High school diploma or GED required.
- Coding certification with 4 years of coding experience, or 7 years of coding experience.
- At least two years of experience in medical billing required.
- Knowledge of medical terminology and coding, including ICD-9, ICD-10, CPT and HCPCS required.
- Demonstrated ability to effectively work with others required.
- Demonstrated problem-solving skills in order to resolve complex billing issues required.
- Knowledge of collection law and practices preferred.
- Knowledge of local and major national medical insurance practices preferred.
- Knowledge of proper business writing standards for letters and memos including the ability to write correspondence with proper punctuation, grammar, spelling, etc.
- Proven effective verbal, listening and written communications skills.
- Knowledgeable in Microsoft Office Products (Word, Outlook), the internet and navigating insurance websites.
- Ability to demonstrate The Values Statement and The Patient Experience of WHA.
- Ability to perform the essential functions of the job.
Women's Healthcare Associates, LLC is an equal opportunity employer.
Oregon employers are required by a number of state and federal agencies to display a variety of workplace notices and posters, including:
Federal Family and Medical Leave Act
https://www.dol.gov/whd/regs/compliance/posters/fmlaen.pdf
Oregon Family Leave Act
www.oregon.gov/boli/TA/docs/oflaposter2016englishlarge.pdf
