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Posted: Monday, May 29, 2017 12:05 AM

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Company Name: Trillium Health

Required Travel: None
Min Education: Associate
Min Experience: 5-7
Job Function: Coding - Outpatient, Coding - Physician Services, Coding - Post Acute, Hospital/Health System Administration, Medical Billing
Job Type: Full-Time

Description
Works all patient and client accounts to industry-specific applications to include invoice creation, billing and posting receivables, i.e. eMD’s, Medent, AIRS, NetSmart, Scriptpro, TPMS, Trizetto, Emdeon, Ability, FundEZ. Audit all patient charts to ensure correct coding. Train medical staff on coding/billing changes. Maintain the cash receipts log, prepare deposits, complete general ledger entries, and reconciliations.

Coding/Auditing
• Evaluates medical record documentation and encounter coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit, and to ensure that data comply with legal standards and guidelines.
• Interprets medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct ICD 10, CPT codes and HCPCS II.
• Reviews Medicaid and Medicare reimbursement claims before submission for completeness and accuracy and to minimize claim denial.
• Assists staff in making changes to the electronic medical record master file as required.
• Provides technical guidance to clinical providers and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to approved coding principles/guidelines.
• Educates and advises staff on proper code selection, documentation, procedures and requirements.
• Identifies training needs, prepares training materials, and conducts training for clinical providers and support staff to improve skills in the collection and coding of quality health data.
• Measure and report trends in provider coding

Billing Process
• Evaluate encounters for completeness and ability to be billed.
• Submit third party claims to payers for processing
• Work denials and rejections from clearinghouse and payers
• Resubmit denied claims as necessary
• Patient contact to resolve billing problem
• Aggressively follow-up on collection of aged accounts receivable
• Interact with Case Management staff on insurance problems
• Compliance activities as directed

Payment Processing
• Post third party remittances
• Post payments received on patient and client accounts to eMD’s, Medent and AIRS in a timely manner.
• Work denials and rejections from payers
• Reconcile industry-specific applications, i.e., eMDs, AIRS, Medent, Scriptpro, TPMS, FundEZ, to general ledger and resolve differences in a timely manner

Credentialing
• Maintain Provider insurance panels and credentialing
• Assure all payer contracts are up to date and maintained

Cash Receipts
• Post cash receipts (electronic) to the general ledger in a timely manner.
• Prepare Bank Deposit
• Balance deposits from the Pharmacy and Clinic to the general ledger

Miscellaneous
• Provide support within the Finance dept. in the event of another staff member’s absence.
• Requires the ability to relate to people of diverse backgrounds, cultures, races, sexual orientations and gender identities or expressions.
• Responsible for maintaining confidentiality of all patient, client, proprietary and protected information.
• Miscellaneous filing, copying, faxing, etc. as needed to support Finance staff.
• Employees are accountable for meeting performance standards of their departments. They participate in compliance audits and quality improvement plans.
• Other job duties as assigned by supervisor.

Qualifications
Associates’ degree in a relevant field plus 5 years’ experience in medical billing/coding. Valid Coding Certification required (CPC, CCS, CMC). Proficiency in Microsoft Excel and Word required. Must have a positive attitude, good attention to detail, be willing to take initiative and exercise good judgment. Must be reliable, highly organized and able to prioritize and juggle a variety of activities.

Contact Person: Sherry Thomas
Email Address: sthomas@trilliumhealth.org
Phone: 585-210-4246
Fax: 585-244-6456

• Location: Rochester, Rochester, New York

• Post ID: 24347008 rochester
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