Patient Accounts Specialist

Perform duties in the billing division related to all aspects of the revenue cycle to include data entry, denials, patient interaction, patient account research, and insurance follow-up and extracting appropriate CPT and ICD-10 codes.

Responsibilities:

• Review H&P and surgeon’s documentation for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
• Research and analyse data needs for reimbursement.
• Analyse medical records and identify documentation deficiencies.
• Serve as resource and subject matter expert to other coding staff.
• Review and verify that documentation supports diagnoses, procedures and treatment results.
• Identify diagnostic and procedural information.
• Audit clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
• Assign codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.
• Follow coding conventions.
• Serve as coding consultant to care providers.
• Identify discrepancies, potential quality of care, and billing issues.
• Research, analyse, recommend, and facilitate plan of action to correct discrepancies and prevent future coding errors.
• Identify reportable elements, complications, and other procedures.
• Assist in orienting and training staff.
• Provide ongoing training to staff as needed.
• Create charge encounters by entering CPT and ICD10 codes in the Electronic Health Record (EHR) system.
• Research and resolve insurance denials.
• Process – posting claims and manage/work rejections.
• Review claim and discuss overdue balance with patients.
• Register and update patient demographics in IDX.
• Calculate patient deductibles and co-insurance payment amount.
• Develop payment plans and make payment arrangements for outstanding balances.
• Assist patients/customers with insurance information and balances.
• Handle special projects as requested.
• Ensure doctor(s) submit notes in a timely manner in order to process claims efficiently.
• Verify insurance information by calling carrier if applicable.
• Respond to inquiries from patients and research accounts.
• Must possess the ability and skill to independently work in a team environment.
• Perform other duties as assigned.

Qualifications:

• 1 year experience working with CPT & ICD 10 coding and billing required.
• Current CPC certification is required, or must obtain within 1 year of employment.
• Medical applications software experience, Allscripts/IDX preferred.
• Experience with linking ICD10 to CPT codes to support medical necessity.
• Knowledge of payor guidelines.
• Experienced with using modifiers.
• Ability to extract a written diagnosis from the medical record to assign an ICD10 code.

Location: US-VA-Norfolk