Aurora Health Care · 1 day ago
Prebilling Coding Specialist - Revenue Cycle
United States
Full-time
Remote
Mid Level
$24/hr - $37/hr
3+ years expAurora Health Care is a health services provider, and they are seeking a Prebilling Coding Specialist to ensure accurate claim generation and account corrections. The role involves reviewing patient records, coordinating corrections, and maintaining compliance with coding standards and regulations.
Health Care
Responsibilities
Edit and correct or coordinate the correction/review of edits generated on the 3M OCE/EAPG report
Based upon a daily review of the OCE/EAPG report, review alert against patient record to determine the appropriateness of corrections to patient's accounts
Make revisions with the utmost attention to accuracy to ensure correct claim generation
Demonstrate and maintain proficiency in what constitutes an appropriate correction to a patient's account, the appropriate party to make the correction, and the data which substantiates a correction
Document activities in a clean and concise manner in the Allegra system
Responsible for the filing, security, confidentiality, retention and storage of all government and private documents initiated in unit
Combine Accounts According To Payer Requirements When Appropriate
Correctly identify when accounts are related or unrelated services by reviewing the clinical data contained in the patient's medical record
Review and combine accounts in a timely manner, specifically, prior to the generation of the claim
Demonstrate and maintain proficiency in properly combining accounts and/or charges according to payer policies and regulations
Contacts physicians and other health care professionals and hospital department representatives to obtain needed information required for the correct assignment of CPT-4/HCPCS, modifiers and charges for outpatient services
Responsible to read and understand all Advocate SRCO policies and departmental collections policies and procedures
Maintains knowledge of HIPAA regulations within the scope of the position and carry out job duties in a manner consistent with these regulations ensuring action is taken within guidelines set forth
Review and combine accounts in a timely manner, specifically, prior to the generation of the claim
Must attend and participate in and understand information presented at department meetings
Directs all questions or needs for clarification to management to ensure training needs are readily identified and addressed
Identifies and makes recommendations for process improvements
Responsible to read and understand all correspondence from Government Regulatory Agencies, Payer Updates, etc
Keeps abreast of all system requirements and changes. Achieves proficiency in all applicable functions of the patient accounting systems
Assists in completing ad hoc projects and related job activities as assigned to support department operations. During periods of high volume and/or impending deadlines, assignments may include assisting with patient accounting activities and functions typically performed by other SRCO positions
Maintains current knowledge of ICD-CM and CPT/HCPCS coding systems, as well as APCs and other outpatient reimbursement methodologies and maintains coding credential certification and maintains HIM and/or coding certification credential with AHIMA
Attends internal and external educational seminars and inservices to satisfy continuing education requirements and maintain certification
Reviews the periodicals provided to remain abreast of changes that will affect coding and reimbursement methodologies
Participates in peer review activities to assess coding and abstracting accuracy
Responsible for personal and professional growth and development
Seeks assignments and special projects to facilitate growth towards potential advancement
Keeps abreast of current practices via literature, educational offerings, professional affiliations, etc
Acquires and maintains knowledge of all insurance regulations, local, state, and federal legislation and regulatory agencies and activities which may affect SRCO operations
Qualification
Required
Certified Coding Specialist (CCS) credential for inpatient or outpatient coding positions or Certified Coding Specialist-Physician based (CCS-P) for outpatient coding positions
Completion of coding certificate program from recognized community college (typically 20 semester hours of college credit courses) or significant coding experience prior to earning CCS or CCS-P credential
Registered Health Information Technician (RHIT) with associate's degree in health information technology from accredited program or Registered Health Information Administrator (RHIA) with bachelor's degree in health information administration from accredited program
3-5 years of recent acute care hospital outpatient coding experience
Experience with the 3M OCE report or experience in charge capture determination in a complex department such as the emergency department
Achieve satisfactory score on Advocate's coding test
Attention to detail (such as interpretation of clinical data including medical terminology and disease processes)
Analytical skills for abstracting of clinical data
Ability to interpret regulatory and payer rules and directives concerning coding
Computer experience
CCS, CCS-P, RHIT/RHIA
Ability to listen to and understand information and ideas presented verbally and in writing
Consistently exercises critical thinking skills or uses logic and reasoning to assess and resolve problems
Quickly makes sense of, combines and organizes information
Consistently maintains a professional and approachable demeanor
Able to work under pressure and meet stringent deadlines in a fast-paced environment
Able to work independently
Pays strong attention to details and maintains high degree of accuracy
Successfully alternates between two or more activities or sources of information
Accepts responsibility and maintains high level of accountability
Strong collaboration skills
Available to respond to patient/third party requests during scheduled shift
Ability to work on a computer for extended periods of time
Ability to speak on phone throughout a daily assigned shift (with opportunity to alternate between sitting and standing if necessary)
Ability to work effectively in an open floor environment
Lifting a minimum of 10 pounds
Company
Aurora Health Care
At Aurora Health Care, helping people live well is what drives us – it’s our purpose and what we do every day.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Kristie Geil DNP, RN, CENP
Area VP/CNO Aurora Health Care, South Wisconsin, VP/CNO Aurora Medical Center Kenosha
Carla LaFever
Chief Clinical Services Officer
Recent News
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