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Coder Specialty
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Houston, TX Houston, Texas |
About this job
Baylor St. Luke's Medical Center is a quaternary care facility that is home of the Texas Heart Institute, a world-class cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD--consistently ranked as one of the nation's best in Cardiovascular Services & Heart Surgery. The first hospital in Texas and the Southwest designated a Magnet hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award four consecutive times. Baylor St. Luke's is home to three freestanding community emergency centers (Holcombe, Pearland, and San Felipe) offering adult and pediatric care--treating more than 51,000 patients annually. The hospital holds a collaborative partnership with Baylor College of Medicine and affiliations with The University of Texas Medical School at Houston, The University of Texas Medical Branch (Galveston), Houston Baptist University, and Prairie View A&M University.
Responsible for reviewing the patient
billing process and the charge capture process for all Radiology sections.
Critical thinking skills must be applied to determine the best means by which
the charges should be applied to each patient's account. Analytical skills must
be used to determine if all charges are appropriate and to ensure the pertinent
charges have been applied. In addition to directly applying debits and credits
to patient accounts, the data entered is the basis of all clinical credits to
patient accounts and statistical reporting can be generated for all sections of
Radiology.
Minimum Job Qualifications
Minimum Education:
*Associate's Degree or completion of a Health Information Coding
Certification Program
*Must have current certification from, American Health
Information Management Association (AHIMA), National Healthcare Association
(NHA), Radiology Coding Certification Board (RCCB),or American Academy of
Professional Coders (AAPC)
*Experience in Radiology coding required if
certified by AHIMA, NHA or AAPC
*Acceptable certifications are RHIT, RHIA,
CCA, CCS, CCS-P, CPC, CPC-H, CHC, COC, RCC, CIRCC, CCVTC,
Minimum years in field previous to
employment: Two (2) years of relevant experience
1. Analyzes and interprets patient medical records within the Radiology sections
in order to determine if the amount and nature of billable services are
accurate.
2. Utilizes advanced, specialized knowledge of medical codes and
coding procedure to assign and sequence appropriate diagnostic/procedure billing
codes in compliance with third party payer requirements.
3. Interacts with
radiology management, staff, physicians and other patient care providers
regarding billing and documentation policies, procedures, and regulations.
Obtains clarification of conflicting, ambiguous, or non-specific
documentation.
4. Monitors billing performances to ensure optimal
reimbursement while adhering to regulations prohibiting unbundling and other
questionable practices; reviews radiology charge capture reports daily and
compares with daily department statistical reports to ensure all billable
charges are applied and Prepares periodic reports for clinical staff identifying
unbilled charges due to miscellaneous errors.
5. Performs routine audits and
analysis of payer denials; Provides information on compliance issue arising from
audits and formulates recommendation to providers regarding improved
documentation practices to avoid future claims denials.
6. Interacts with
department head and other administrative staff regarding implementation of new
codes and revision of charge documents.
7. Researches inquiries from
providers and patients regarding fees, reimbursements and denials.
8.
Monitors external data sources to ensure receipt and analysis of all
charges.
9. Assists in training and Provides assistance and support to new and or current
staff to ensure charge capture process is addressed.
10. Ensures strict
confidentiality of financial and patient information is maintained.
11.
Attends coding conferences, Workshops and in-house sessions to receive updated
coding information and changes in coding and/or regulations.
12. Follows
established departmental policies and procedures, continuous quality improvement
objectives and safety and environmental standards.
13. Ensures effective
customer service is emphasized, as appropriate, to all patients, family,
visitors, staff and physicians.
14. Ensures that our charge capture process
and billing codes are reviewed and are appropriately applied, including auditing
to ensure compliance is maintained in accordance with Medicare/ Medicaid,
insurance providers, TDH, JCAHO and other regulatory agencies.
15. Develops
procedures to monitor financial data through charge reconciliation, and prompt
follow-up with coders, auditors, management, physicians and patient financial
services.
16. Evaluates departmental procedures and makes recommendations
for process redesign to improve departmental charge capture and billing
efficiency and improve patient/customer satisfaction.
17. Validates data is
accurate and customized to reflect actual services provided for true "apples to
apples" database comparisons.
Responsible for reviewing the patient
billing process and the charge capture process for all Radiology sections.
Critical thinking skills must be applied to determine the best means by which
the charges should be applied to each patient's account. Analytical skills must
be used to determine if all charges are appropriate and to ensure the pertinent
charges have been applied. In addition to directly applying debits and credits
to patient accounts, the data entered is the basis of all clinical credits to
patient accounts and statistical reporting can be generated for all sections of
Radiology.
Minimum Job Qualifications
Minimum Education:
*Associate's Degree or completion of a Health Information Coding
Certification Program
*Must have current certification from, American Health
Information Management Association (AHIMA), National Healthcare Association
(NHA), Radiology Coding Certification Board (RCCB),or American Academy of
Professional Coders (AAPC)
*Experience in Radiology coding required if
certified by AHIMA, NHA or AAPC
*Acceptable certifications are RHIT, RHIA,
CCA, CCS, CCS-P, CPC, CPC-H, CHC, COC, RCC, CIRCC, CCVTC,
Minimum years in field previous to
employment: Two (2) years of relevant experience
1. Analyzes and interprets patient medical records within the Radiology sections
in order to determine if the amount and nature of billable services are
accurate.
2. Utilizes advanced, specialized knowledge of medical codes and
coding procedure to assign and sequence appropriate diagnostic/procedure billing
codes in compliance with third party payer requirements.
3. Interacts with
radiology management, staff, physicians and other patient care providers
regarding billing and documentation policies, procedures, and regulations.
Obtains clarification of conflicting, ambiguous, or non-specific
documentation.
4. Monitors billing performances to ensure optimal
reimbursement while adhering to regulations prohibiting unbundling and other
questionable practices; reviews radiology charge capture reports daily and
compares with daily department statistical reports to ensure all billable
charges are applied and Prepares periodic reports for clinical staff identifying
unbilled charges due to miscellaneous errors.
5. Performs routine audits and
analysis of payer denials; Provides information on compliance issue arising from
audits and formulates recommendation to providers regarding improved
documentation practices to avoid future claims denials.
6. Interacts with
department head and other administrative staff regarding implementation of new
codes and revision of charge documents.
7. Researches inquiries from
providers and patients regarding fees, reimbursements and denials.
8.
Monitors external data sources to ensure receipt and analysis of all
charges.
9. Assists in training and Provides assistance and support to new and or current
staff to ensure charge capture process is addressed.
10. Ensures strict
confidentiality of financial and patient information is maintained.
11.
Attends coding conferences, Workshops and in-house sessions to receive updated
coding information and changes in coding and/or regulations.
12. Follows
established departmental policies and procedures, continuous quality improvement
objectives and safety and environmental standards.
13. Ensures effective
customer service is emphasized, as appropriate, to all patients, family,
visitors, staff and physicians.
14. Ensures that our charge capture process
and billing codes are reviewed and are appropriately applied, including auditing
to ensure compliance is maintained in accordance with Medicare/ Medicaid,
insurance providers, TDH, JCAHO and other regulatory agencies.
15. Develops
procedures to monitor financial data through charge reconciliation, and prompt
follow-up with coders, auditors, management, physicians and patient financial
services.
16. Evaluates departmental procedures and makes recommendations
for process redesign to improve departmental charge capture and billing
efficiency and improve patient/customer satisfaction.
17. Validates data is
accurate and customized to reflect actual services provided for true "apples to
apples" database comparisons.
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