Tri-City Medical Center · 1 day ago
Billing/Coding Specialist
Oceanside, CA
Full-time
Onsite
Entry Level
1+ years expTri-City Medical Center is a full-service acute care public hospital in San Diego County, committed to providing quality healthcare to the community. The Billing/Coding Specialist is responsible for accurately coding physician diagnoses and procedures, ensuring compliance with medical billing policies, and managing patient invoicing and insurance claims.
Emergency MedicineHealth CareHospitalRobotics
Responsibilities
Maintains a safe, clean working environment, including unit based safety and infection control requirements
Utilizes EHR for any documentation needed to support coding of a claim
Efficiently assigns ICD-10-CM, CPT-4 and HCPCS codes for surgeries from documentation based on the most current guidelines
Reviews note prepared by physician and ensures that no mistakes are made in those notes
Contacts physician if information is missing and gets the information filled in and/or corrected
Makes sure all medical record files are complete (including timed, dated, and signed)
Assigns modifiers based on payor guidelines
Understands documentation and compliance requirements for assigning of codes
Maintains strictest confidentiality and follows HIPAA guidelines for protecting Protected Health Information (PHI)
Processes and submits electronic claims
Corrects electronic rejection edits
Ensures all NCCI edits are resolved within 2 business days to ensure claims are submitted within 5 days from service date
Prints paper claims as needed
Provides cash quotes for self-pay surgeries
Quotes and collects cash for non-covered procedures and injections
Follows up to see if claim is accepted or rejected
Investigates rejected claim to see why denial was issued
Performs other duties all other duties as assigned
Qualification
Required
Minimum of 1 year of experience in health care
Demonstrates a good working knowledge of medical terminology, human anatomy and coding methodology
Possesses moderate knowledge of Level 1 & 2 modifiers
Ability to examine documents for accuracy and completeness
Detail oriented with ability to identify and resolve problems
Must possess moderate knowledge of NCCI, CCI edits and LCDs and be able to accurately apply regulation knowledge to coding situations
Ability to communicate clearly and work effectively with co-workers
Strong ethics and a high level of personal and professional integrity
Strong analytical skills
An effective communicator at all levels in the organization, with strong oral, written and persuasive skills
High school diploma or GED, required
Certificate or Diploma from an Accredited Program in Medical Coding
Current CPC, CPC-A, CCS, or RHIT certification, required
Company
Tri-City Medical Center
Tri-City Medical Center is an acute-care hospital that provides robotic surgery, heart care, emergency services, and many more.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$33MKey Investors
Department of Health Care Access and Information
2023-08-24Debt Financing· $33M
Leadership Team
Ray Rivas
CFO & Executive VP
Aaron J. Byzak, MBA, FACHE
Chief Strategy Officer (CSO)
Recent News
San Diego Union-Tribune
2024-05-24
San Diego Union-Tribune
2024-05-24
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