Employer: Virginia Mason Memorial
The Billing and Coding Specialist is responsible for accurate patient registration information, performing and obtaining payer financial coverage verification, service approvals, and utilization requirements and provides assistance in the areas of both Medical Billing and Coding. Performs accurate daily processing of all coding and/or claims output, meeting agency/payor transmission deadlines.Assigns appropriate revenue, procedure, and diagnosis codes after thorough review of medical records, clinical visit notes, and resource materials. Acts as a resource for team members as wells a clinical staff ensuring coding practices fall within established compliance guidelines for ICD-9, ICD-10 and CPT codes. Processes all phases of the revenue cycle. Reviews demographic information, codes, charges, and corrects claims to meet specific payer requirements. Use critical thinking skills to bill services compliantly and question areas of uncertainty. Obtains authorizations for services in accordance with payor contracts and regulatory guidelines and effectively communicates these authorizations with applicable staff. Accurately enters data for billing to be generated as well as effectively utilizes computer software programs for encoding. Analyzes and performs efficient pre-billing audits, account activity research, identifies solutions, and initiates an appropriate course of action; documents actions and notes in the EMR as appropriate. Works with payors/patients to review denials, assure proper billing requirements, and initiate changes as needed.
QUALIFICATIONS AND REQUIREMENTS
Education: High School diploma or equivalent required. Post high school education and training in ICD-9/ICD-10 and/or CPT coding required. Associate and/or Bachelor’s degree in related field preferred. Education may be substituted depending on experience.
Experience: Experience in a medical billing and/or coding in an outpatient setting preferred.
Licenses/Certificates/Registration: CPC, CAA Preferred.
Level of Business Knowledge/Knowledge/Skills/Abilities: Medical terminology/clerical/customer service experience required. Understanding of ICD 9, ICD 10 and CPT codes preferred.
Location: Yakima, WA
Application Method: https://pm.healthcaresource.com/CS/yakimavalley/#/job/11341
Base Pay: DOQ