Essential Job Functions
• Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
• Educates staff in accurate documentation, coding, billing and reimbursement with primary emphasis on educating the providers.
• Coordinates and completes coding, reimbursement, compliance, and internal audits including any monitoring activities that require a review of relevant information. Such reviews may be part of the annual audit work plan or as assigned throughout the year. Audits data to ensure that coding and documentation at Billings Clinic meets set standards.
• Reviews, analyzes and interprets coding changes and billing regulations and disseminates information. Monitors and audits records for compliance with regulatory changes in documentation.
Analyzes and researches government and third party payer policies and updates for coding and reimbursement content. Appeals for changes in these policies when appropriate.
• Researches and audits new technologies and new service lines for compliant coding, documentation requirements in conjunction with reimbursement information... Meets with equipment and drug vendors to ensure proper reimbursement for new equipment/products.
• Coordinates effort to ensure that charge masters are updated appropriately on a regular basis. This includes participation in annual CDM/Code reviews, identifying enhancements in fee structure and making sure that electronic charge capture tools are accurate.
• Responsible for coding and abstracting diagnoses and procedures from patient charts using ICD and CPT/HCPCS codes for statistical and reimbursement purposes for all Billings Clinic inpatient and outpatient services.
• Researches and responds to questions from Billings Clinic leadership and staff. Performs other duties as assigned or needed to meet the needs of the department/organization. May conduct other special projects as assigned.
Minimum Qualifications
Education
• High school graduate or equivalent
Experience
• Two years experience in a multi-specialty clinic and/or hospital working with ICD-CM, CPT-4/HCPCS, and/or DRG coding
• Previous demonstrated experience in a clinical setting performing technical responsibilities related to ICD-CM, CPT-4/HCPCS coding, fees, and reimbursement
• Demonstrated ability to understand and develop information using databases and create complex spreadsheets. Intermediate knowledge of Microsoft Office products, including Word, Excel, and PowerPoint.
Certifications and Licenses
• Credential as Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or other recognized AAPC or AHIMA credentials at hire
Or an equivalent combination of education and experience relating to the above tasks, knowledge, skills and abilities will be considered. Employees that require a licensed or certification must be properly licensed/certified and the licensure/certification must be in good standing.
Coding Resource Advisor • BILLINGS, MT, United States
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