Code correctly all applicable diagnosis, procedure codes, and modifiers related to the admission, observation or procedure utilizing appropriate CPT, ICD-10, and HCPCS codes.
Prepare charges for data entry. Include complete information regarding diagnosis, service/procedure codes, and any additional information needed for reimbursement.
Ensure charge capture by reviewing census and/or O.R. schedule(s) daily.
Review and correctly code any clinical encounter sessions that fall into any relevant coding workqueues.
Act as a coding resource to assigned divisions
ESSENTIAL RESPONSIBILITIES
Code correctly all applicable diagnosis, procedure codes, and modifiers related to the admission, observation or procedure utilizing appropriate CPT, ICD-10, and HCPCS codes.
Prepare charges for data entry. Include complete information regarding diagnosis, service procedure codes, and any additional information needed for reimbursement.
Ensure charge capture by reviewing Census and O.R. schedule(s) daily.
Act as a coding resource to assigned divisions.
Keep abreast of all current CMS and insurance plan coding requirements.
Register off-site inpatient and outpatient demographics as needed by accurately entering patient demographic, guarantor and coverage information into the Professional Billing computer package.
Data entry of charges into the Professional Billing computer package as needed following Charge Entry workflow and Standard Business Practice for Reconciliation of Charge Batches.
Configure and run Charge Entry report daily
Proficient in Professional Billing application(s).
Know and use data entry ground rules for data entry.
Know and follow Standard Business Practices and where to locate both hard copy and electronic versions.
Work well with DAG team to obtain necessary coverage's and/or authorizations.
Demonstrate excellent customer service that promotes patient, staff, and customer satisfaction and reflects the mission, vision, and values of Nemours.
Understand and utilize Nemours Intranet and Managed Care Manual.
Keep abreast of all insurance and system changes/updates.
Maintain strict confidentiality.
Maintain annual/new hire training as required.
Perform other duties as assigned by leadership.
POSITION QUALIFICATIONS
Education, Training and Experience
High School Diploma or equivalent.
Basic word processing and computer skills required.
Basic knowledge of insurance plans and requirements required.
Medical terminology required.
CPC and/or CCS-P required. Expectation that individual will actively work toward and obtain certification within the first two years of employment.