Claims Edit Coder Jobs in Philadelphia, PA (NOW HIRING)

OVERVIEW

• Serves as a role model for Holy Redeemer to patients, residents, families, co-workers and visitors.

• Maintains a positive and professional demeanor

• Acts in a respectful, supportive and empathetic manner.

• Provides appropriate and timely responses to customer concerns or requests.

• Demonstrates the Holy Redeemer Mission, Vision, Values and Culture.

• Demonstrates effective, courteous and respectful communication skills.

• Presents ideas in a clear and concise manner

• Accepts responsibility for own work.

• Assists coworkers and helps with other duties as assigned.

• Adapts to changing priorities and business needs.

• Participates in in-services and other functions.

SUMMARY OF JOB

• Accurately and efficiently access practice and hospital information systems to secure and assemble all necessary demographic records to accurately bill medical services.

• Prepares source data for computer entry by compiling and sorting information, establishing data entry priorities

• Perform registration into practice information system to ensure demographic and insurance information is accurate, complete and verified.

• Assemble and enter coding results into the current practice management billing system to expedite compliant and proper billing

• Completes coding and charge entry based on assigned specialties and associated responsibilities

• Produce and submit claims to insurance companies, and research denied claims for re-billing

• Work with assigned practice(s) and Revenue Cycle Specialists to ensure claim processing and submission is completed timely and efficiently

• Correct, note, and ensure all assigned claims on HOLD are re-scrubbed and submitted where directed

The Leadership Team develops Holy Redeemer’s vision, objectives, strategies and tactics to achieve our mission in a way that engages both the imagination and the energies of our employees. Leaders reflect the unique strengths, values, culture, and beliefs of Holy Redeemer, inspiring all employees to Care, Comfort, and Heal for our patients, residents, clients, and each other. The Finance Department strives to contribute to this mission by working with the entire organization to provide the most positive financial climate possible, for continued caring, comforting, and healing for all in need.

RECRUITMENT REQUIREMENTS

• High School Diploma/GED

• Demonstrates knowledge of insurance regulations and requirements

• Demonstrates excellent organizational and verbal and written communication skills

• Computer Skills: Proficient with Microsoft products (Excel, Word, Outlook), Knowledge of PC based electronic billing systems; Experience with hospital and physician billing systems preferred

Core Responsibilities:

• Works cohesively with assigned practices to ensure that the entirety of claim processing, from registration/eligibility and charge entry to claim submission is completed in tandem with Revenue Cycle Specialists in a streamlined and effective manner

• Receives, researches and addresses denied claims in conjunction with the Revenue Cycle Specialist, and re-submits claims once appropriate corrections have been rendered

• Accesses Hospital and Practice Information systems to obtain demographic and insurance information

• Ensures insurance information, including required authorization, has been verified and entered accurately

• Confirms that all batches contain required documents for successful billing cycles

• Reconciles charges entered with daily flow sheets

• Reviews charges for accuracy

• Verifies correct coding with Medical Records and makes all necessary corrections

• Accesses and updates Quickview, Registration, and Patient Account Notes, Appointment, and Claim Edit screens in practice management system

• Notifies supervisor/team leader of any backlog or unresolved problems impacting timely billing

• Monitor and execute work against the assigned specialty/worklists and team associated department goals

EQUAL OPPORTUNITY

Redeemer Health is an equal opportunity employer. We prohibit discrimination in employment due to race, color, gender, religion, creed, national origin, age, sex, sexual orientation, gender identity or expression, disability veteran status or any other protected classification required by law.