Certified Medical Coder - Division of Ophthalmology
Children’s Hospital of Philadelphia
- Philadelphia, PA
- $27.35-34.19 per hour
- Permanent
- Full-time
This role is responsible for preparing and entering surgical and in-patient billing for the Division, ensuring the accuracy of outpatient billing and assisting with account reviews/account receivable / appeals follow up.This role will be responsible for reviewing medical record documentation and timely charge submissions and or data entry of the coded billing services.What you will do
- Ensures timely and accurate release of all outpatient charges.
- Reviews the patient's EMR including visit notes, Op Notes, inpatient consult notes, etc. and abstracts/confirms CPT Procedure codes and ICD-10 codes for all surgeries and inpatient encounters and enters into billing system.
- Ensures pre-certifications/authorizations are valid for the procedure performed.
- Performs daily maintenance on divisional billing work-queues.
- Assists in finding resolutions to billing issues : rejections, non-paid accounts, etc.
- Communicates with families, assisting with billing/insurance questions and collecting surgical prepayments.
- Maintaining thorough knowledge of coding and documentation requirements outlined by CPT, ICD-10 CMS and CHOP Compliance for all physician services performed.
- Supports special projects assigned by Manager.
- High School Diploma / GED Required
- At least three (3) years experience in health insurance billing or reimbursement. Required
- At least one (1) year coding experience Required
- Advanced knowledge of specialty coding.
- Advanced knowledge of ICD10, third party procedures, and requirements regarding benefit structures, insurance verification, referrals and authorizations.
- Advanced knowledge of general financial counseling and the revenue cycle.
- Familiarity with electronic health records (EHR).
- Intermediate proficiency with office software (Microsoft Office) including word processing and spreadsheet software (Word, Excel)
- Excellent verbal and written communications skills
- Excellent interpersonal skills
- Strong critical thinking / problem-solving skills
- Strong analytical skills
- Ability to maintain confidentiality and professionalism
- Ability to work independently with minimal supervision
- Ability to gather, analyze and make recommendations/decisions based on data
- Ability to convey complex or technical information in an easy to understand manner