Medical Records Coder/Accounts Resolution Specialist

Description

The Medical Records Coder/Account Resolution Specialist is responsible for the coding of clinical records using the coding system and researching, resolving, and collecting on accounts. This is a full-time position with benefits including medical, dental, vision, life insurance, short and long-term disability, retirement, accrued time off, holiday pay, and other supplemental plans. 

ESSENTIAL FUNCTIONS/RESPONSIBILITES:

· Performs coding of clinical records, sequences diagnoses and procedures, and assigns DRG’s to facilitate the billing process.

· Monitors charts for medical necessity and alerts providers.

· Acts as a resource for questions regarding coding and billing procedures.

· Ensures that records are coded within a timely manner usually within 24 hours after chart is ready for coding.

· Codes medical records of discharged patients, Emergency Room patients, Clinics, and Outpatients, thoroughly reviewing charts to ascertain all pertinent diagnoses and procedures.

• Maintains and ensures patient confidentiality at all times following all HIPAA regulations.

• Responds to requests for information in a professional and courteous manner.

• Participates in quality and performance improvement activities, both departmental and hospital wide.

· Responsible for providing quality customer service while performing and resolving patient account issues.

· Researches and resolves clinic or hospital billing issues and complete necessary follow-up correcting any incorrect claims.

· Reviews clinic and/or hospital accounts; Codes and updates charges and adds modifiers. 

· Monitors charges, making sure they are correct.

· Daily deposit verification.

· Help cover the Switchboard if needed.

· Works ques in SSI or Emergency if applicable.

· Perform other assigned duties as necessary to support the Business Office or as assigned by supervisor.

· Informs management of any operational issues or customer satisfaction issues.

· Check email daily.

• Maintains and ensures patient confidentiality at all times.

• Reports to work on time and as scheduled; completes work within designated time frames.

• Attends staff meetings as scheduled. 

• Represents the organization in a positive and professional manner.

• Adheres to JPH policies and procedures.

This description is a general statement of required essential functions performed on a regular and continuous basis. It does not exclude other duties as assigned.

Requirements

  EDUCATION, TRAINING, AND EXPERIENCE:

· High School graduate or equivalent. Associates degree or equivalent in work experience required.

· Knowledge in medical and anatomical terminology preferred.

· Knowledge of classification systems and coding guidelines.

· Knowledge of Medicare and other third-part billing requirements is preferred.

· Minimum of (2) years of related work experience in a health care setting preferred.

· ICDIO & CPT Code knowledge preferred.

· Insurance knowledge preferred.

LICENSURE/CERTIFICATIONS:

· RHIA, RHIT, or CCS required.

LANGUAGE AND PROFICIENCY REQUIREMENTS:

• Able to communicate effectively in English, both verbally and in writing. 

• Strong written and verbal skills.

SKILL REQUIREMENTS:

· Ability to work alone or with minimal supervision.

· Professional/Courteous rapport with patients, families, co-workers, physicians and visitors.

· Ability to work under and handle stress in an appropriate manner.

· Ability to work long hours between breaks and meals, if necessary. 

· Basic computer competency. Must be proficient in Microsoft Word and Excel.

MACHINERY/TOOLS/EQUIPMENT REQUIREMENTS:

· Ability to operate and troubleshoot telephone, fax machine, copy machine, computer, and printer/scanner.