Employer: Yakima Valley Memorial Hospital
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.
•Use billing, third party software and critical thinking skills to identify discrepancies and edit accounts accurately, as required for each payor.
•Utilizes reporting from various software for routine monitoring and follow-up on accounts and activity; communicates with Leadership
•Obtains payment commitments and assures timely collection.
•Analyzes and performs efficient problem account activity research, identifies solutions, and initiates appropriate course of action.
•Effectively clarifies and educates on account activity, charges, payments and adjustments to patients or other departments/staff as needed.
•Use critical thinking skills to determine proper application and timely system entry of coding, payments and adjustments.
•Analyzes and monitors payer remittances, identifies inappropriate payer payments and adjustments, post payments to accurately to patient accounts.
•Performs detailed statistical analysis of reimbursement trends, including recommendations for corrective actions and policy/procedure drafts as required.
•Maintains up to date knowledge to function and operate with current trends and billing/coding regulatory guidelines
•Identifies opportunities for improving operating efficiencies and utilizing resources.
•Participates in coding and billing audits to assess accuracy and evaluate opportunities for improvement.
•Performs document scanning of financial documents into the EMR.
QUALIFICATIONS AND REQUIREMENTS:
Education: High School diploma or equivalent required. Post high school education and training in ICD-10 and/or CPC-A preferred. 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 Required for Coding roles.
Level of Business Knowledge/Knowledge/Skills/Abilities: Medical terminology/clerical/customer service experience required. Understanding of ICD 9, ICD 10 and CPT codes preferred.
Yakima Valley Memorial (YVM) is a 256-bed acute-care, not-for-profit community hospital that has served Central Washington's Yakima Valley for 70 years. YVM also includes a multispecialty team of more than 300 physicians and 20+ primary care and specialty care locations. Specialty care services include cardiac care, a continuum of cancer care, hospice care, and advanced services for children with special health care needs.
We offer a comprehensive benefit plan including medical, dental, and vision coverage; plus we have a generous 401K plan (with an employer contribution!), competitive compensation, and a diverse workforce that is passionate about patient care. At YVM, we know the best care is provided by employees who are well-supported.
As the region's leading health care provider and Yakima's largest employer, we believe that by inspiring people to thrive, we can transform lives. Our vision at YVM is creating healthy communities one person at a time. With such an important goal, we work together to demonstrate our values of Respect, Accountability, Teamwork, Stewardship, and Innovation for everyone who walks through our doors, patients and coworkers alike. We would love to hear from you!
“Yakima Valley Memorial provides reasonable accommodations to assist qualified individuals in order to perform the essential duties/requirements their job requires. The description is intended to provide only basic guidelines for meeting job requirements and serves as merely a summary rather than a complete listing of duties. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve. This job description does not constitute a contract as employment is at will.”
Location: Yakima, WA
Application Method: Online
Base Pay: DOQ