Certified Medical Billing Specialist

JOB SUMMARY

Under the direction of the Billing Office Lead and Chief Operating Officer, performs various duties to accurately interpret and bill physician charges for physician services. Enters appropriate CPT and ICD-10 codes into EMR/billing system; bills charges.

This is a full-time position, Monday through Friday. This position is eligible for medical, dental, and vision insurance, employer-paid long-term disability insurance, continuing education funds, and PTO.

THE DETAILS OF THE JOB

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services.
• Enters appropriate data into the EMR/billing system by selecting the appropriate codes, diagnosis and modifiers.
• Contacts physicians through management regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing provider surgery logs and other reports of clinical activity to ensure billing is captured for all patients.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the reimbursement staff to answer all inquiries regarding coding and billing for physicians' services.
• Works in coordination with other members of the Billing Office as necessary.
• Meets and exceeds short and long term goals as established for the department.
• Performs duties and job functions in accordance with the policies and procedures established for the department.
• Reports to work, meetings and professional obligations on time as scheduled.
• Participates in administrative staff meetings and attends other meetings and seminars as scheduled.
• Assists in evaluation of reports, decisions, and results of department in relation to established goals.
• Recommends new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed.
• Serves as a member of the Billing Department. Performs duties necessary to ensure the team's projects/goals are completed.
• Takes ownership of special projects, researches data and follows through with detailed action plans.
• Meet the Company’s expectations as described in the VSON Policies and Practices.
• Maintain confidentiality of Personal Identifiable Information (PHI) in accordance with company Policies and State and Federal laws, including OHSA and HIPAA regulations.
• Perform job in accordance with all company safety practices.
• Other duties as assigned.

WHAT IT TAKES TO DO THE JOB

KNOWLEDGE, SKILLS AND ABILITIES

• Knowledge of the EMR and all billing-related functionality.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Knowledge of rules, regulations, procedures, and work performed in the assigned area.
• Skill in performing coding and billing tasks appropriately.
• Skill in establishing and maintaining effective working relationships with managers, administrative staff, other employees, patients, and external parties
• Outstanding communication and telephone skills.
• Skill in managing time remotely while accomplishing goals timely and efficiently.
• Ability to gather and interpret clinical data.
• Ability to work independently in a fast-paced environment.
• Ability to evaluate, improve, and make suggestions for improvement.
• Ability to express ideas clearly and concisely in oral and written form.

EDUCATION, EXPERIENCE AND CERTIFICATES

• High school diploma or GED completion is required;
• Certified Professional Coder with a minimum of five (5) years’ experience with CPT/ICD-9/ICD-10 coding of orthopedic physician services preferred;
• Good working knowledge of medical terminology and anatomy required.

NOTICE

This job description is not intended to be a comprehensive list of activities, duties or responsibilities for this job. The duties, expectations and actions listed for this role may change at any time with or without notice.

EEO STATEMENT

We believe diversity makes us stronger. Vail-Summit Orthopaedics & Neurosurgery provides equal employment opportunities to all employees and applicants without regard to sex, gender identity, sexual orientation, genetics, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.