CODING AND VERIFICATION BILLING REPRESENTATIVE
Job Type: Full-time, non-Exempt
Schedule: Monday–Friday, day shift;
Location: Mishawaka, Indiana
Benefits
We offer a comprehensive benefits package for eligible full-time employees, which includes:
- Medical, dental, and vision insurance
- Health savings and flexible spending account options
- Retirement plan with employer contribution
- Employer-paid life and accidental death & dismemberment (AD&D) insurance
- Employee assistance program (EAP)
- Wellness and healthy lifestyle benefits
- Employee peer recognition program
- Annual anniversary/retention bonus opportunities
- Competitive paid time off (PTO)
Full details of benefits and specific eligibility (including any minimum scheduled hours for certain benefits) are provided during the interview and onboarding process.
ESSENTIAL FUNCTIONS:
ICD-10 Coding:
· MHIN – Download patient records – History/Physicals, Consults, Laboratory.
· Download last few days of progress notes from General Hospitals or call for records.
· Code with appropriate ICD-10 codes.
· Supply all paperwork and coding to admission nurses in a timely manner.
· Call Doctor’s offices when needed for records.
· Research all coding errors on Medicare claims and correct coding in Cerner.
Benefits Verification:
· Verifies medical benefits for Medicare and Medicaid.
· Utilizes MHIN for demographics and insurance information.
· Works closely with referral specialists and Intake Coordinator as necessary for coverage.
· Works with designated staff to communicate/coordinate details of client coverages.
· Follows procedures to input verification information into Cerner and communicates information to Admissions.
Chart Closing:
· Closes Medicare and Medicaid charts.
· Verifies A/R account for payment in full.
· Verifies all proper forms are in charts.
· Completes pink chart closing paperwork.
· Maintains an accurate filing system in the closed chart cabinets.
Administrative Duties:
· Organizes and maintains accurate filing system in discharge, open and staging areas.
· Files LOC print-outs and completed Certifications of Terminal Illness (COTI) in patient charts.
· Maintains discharge charts: noting date discharged, and filing charts alphabetically.
· Opens and date stamps all Medicaid Notification letters and scans the approved and discharge notifications into the patient’s chart in Cerner.
· Puts all letters in the Medicaid Billing Representative’s mail tray and then files all letters in patient’s charts when returned to Billing Assistant’s mail tray.
· Serves as Receptionist as needed at the Center for Palliative Care.
ADDITIONAL FUNCTIONS:
· Committed to Agency resolution against fraud and abuse.
· Knowledgeable in hospice philosophy and state and federal rules and regulations.
· Arrives to work and meetings on time and ready to work.
· Respects confidentiality of patients/families and other Agency employees.
· Attends educational meetings/conferences for professional growth as required.
· Sees change as an opportunity and maintains a level of flexibility which allows for adaption to new ways of performing.
· Follows directions and policies that allow for an organizational commitment to working under time pressures without sacrificing quality.
· Performs other duties that may be assigned.
JOB REQUIREMENTS:
Possess the following abilities:
· Speak in ordinary conversational tones utilizing the English/American language.
· Hear ordinary conversations.
· See with the visual acuity necessary to perform the Essential Functions listed in this Job Description.
· Have simultaneous use of hands, wrists, and fingers (example: writing, typing, data entry)
QUALIFICATIONS:
· High School Diploma
· Medical coders must be knowledgeable about government regulations and insurance payer policies on healthcare and ensure that the coding system meets acceptable standards.
· Minimum of 1 year working with ICD-10 codes.
· Experience working with private insurance companies, Medicare and Medicaid. .
· Strong computer skills required.
· An ability to organize and prioritize work tasks.
· Possesses excellent communication skills.