MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Performs routine and non-routine revenue cycle, billing, coding and insurance functions by:

• Extracting relevant information from patient records, examining documents for missing information.
• Liaison with physicians and other parties to clarify information.
• Analyzing documentation and accurately applies CPT, ICD, and HCPCS codes to support compliant coding.
• Working rejected and denied claims based on assigned reports, and assists in complex denial resolution.
• Communicating updates on coding related changes and billing opportunities and guidelines to supervisor and/or providers.
• Assisting providers with required documentation, compliant coding and reimbursement.
• Monitoring provider documentation for trends and adherence to documentation standards and regulatory requirements through report and billing analysis. Communicates results to providers and management as needed.
• Participating in timely review of provider documentation and communication of results to supervisor.
• Auditing reports as necessary to identify and correct coding related errors.
• Achieving BMG's coding productivity and accuracy rates within 6 months of hire; maintains rates as evaluated by internal or external review.

Performs other functions to maintain personal competence and contributes to the overall effectiveness and efficiency of the department by:

• Working closely with other BMG Central Business Office associates.
• Presenting coding and compliance related topics to team members.
• Completing other job-related duties and projects as assigned.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

• Leverage innovation everywhere.
• Cultivate human talent.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

• The knowledge, skills, and abilities are normally acquired through a High School diploma, GED or suitable equivalent. Graduate of an accredited medical coding program preferred. Two years physician coding experience in an applicable specialty preferred. Designation as a Certified Coding Specialist-Physician Based, Certified Professional Coder, Certified Medical Coder, or Certified Coding Associated required. Must complete a minimum of 12 hours of coding related education per year to field of concentration.

Knowledge & Skills

• Requires accuracy and proficiency with CPT, ICD and HCPCS code assignment.
• Demonstrates knowledge of regulatory and payer specific coding guidelines.
• Demonstrates proficiency in knowledge of anatomy, physiology and medical terminology.
• Demonstrates exceptional organizational skills and attention to detail.
• Proficient computer skills in data entry, coding, and knowledge of Electronic Medical Record software; Microsoft Office Suite.
• Ability to work independently and as a member of a team.
• Requires excellent communication skills, both oral and written, necessary to effectively speak to a diverse audience.
• Demonstrates working knowledge of HIPAA and ability to maintain confidentiality of all data.

Working Conditions

• Works in an office environment.
• May experience some mental/visual fatigue from careful and constant review of records, code books, and continued use of computer equipment.

Physical Demands

• Requires the physical ability and stamina to perform the essential functions of the position.