Billing Specialist II - MSRDP Front End Revenue Cycle
Categories: Insurance / Billing
Department: MSRDP Front End Revenue Cycle
Full/Part Time/PRN: Full-Time
Experience and Education
2. Certified Professional Coder (CPC), Advanced Records Technician (ART), or Registered Records Administrator (RRA) preferred.
2.Performs limited abstracting on E&M services, diagnostic studies, and moderate to minor surgical procedures. Requires the ability to read the progress note and or procedure results and confirm or change the CPT code(s), diagnosis code(s) and modifiers (if applicable). Requires knowledge of the carrier coverage policies and be familiar with the billing practices of the specialty service line. Must be familiar with the Medicare and Medicaid teaching physician documentation billing rules.
3.Investigates and resolves coding and registration Epic Resolute Claim edits. Requires strong knowledge of Epic's carrier registration filing order rules and billing rules.
4.Performs manual charge entry for all non-EpicCare and non-automated sites of services. This includes E&M visits and procedures across several centralized service lines. Depending on the clinical department they may be required to review and release charges from a computer assisted coding environment.
5.Periodically assists in obtaining insurance authorizations and accurately maintaining the authorization records, communicate patient balance and patient-responsibility amounts to clinics and/or patient/families, responding to requests for information. Attend coding and billing in-services to stay current on changes; attend other meetings and training as assigned.
6.Duties performed may include one or more of the following core functions: (a) Directly interacting with or caring for patients; (b) Directly interacting with or caring for human-subjects research participants; (c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or (d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
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