Performs as the CBO liaison for STHS, DHL & FDRMC between ATCBO and Ancillary departments for issues related to billing, coding, medical necessity edits and documentation for all facilities. Reviews unbilled accounts to resolve all Outpatient Code Editor (OCE), National Corrective Coding Initiative (NCCI), Local Medical Review Policies (LRMP) and other edits. Assist the auditing team and participates in monthly charge auditing duties. Assists with review of denials for possible coding or modifier issues. Monitors and maintains appropriate reports as needed.
Excellent customer service skills required. Clinical, Health Information Management, or Patient Financial experience. Advance proficient in Microsoft Office applications and other data mining software. Knowledge of Medical billing, collection practices, CPT, HCPCS and ICD10 Coding. Understand Medicare & Medical assistance regulations as needed. Good verbal communication skills in English/Spanish. Must demonstrate commitment and adherence to STHS's Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer.
Associates Degree or above in Business, Finance, Accounting, Health Information Management or related field required. 6 years of Revenue Cycle experience required in a Healthcare setting, may be considered in lieu of a degree. High School diploma, GED or Higher Education required. Coding certification required, or obtained within 12 months of employment.
Billing Analyst FT ROC • Edinburg, TX, United States
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