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The Billing and Coding specialist will be responsible for increasing business profitability by effectively managing timely medical coding, authorizations, billing/charge entry, accurate coding, analyzing denials, rejections, and seeking the best approach to overturn, and reducing days in accounts receivable.
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This position is responsible for designating appropriate ICD-10 and CPT Codes for specialty focused professional billing in Radiation Oncology at Sentara Virginia Beach General Hospital (SVBGH) as well as patient registration and charge entry of the same.
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This position ensures that the documentation is in compliance with Medicare/Medicaid billing regulations, and provider documentation guidelines, CPT documentation and CMS coding guidelines.
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Minimum of 10 years of healthcare experience working with billing, charge entry, charge capture, and code auditing with knowledge of CPT, HCPCS, ICD-10 codes and modifiers. The Billing Coding Auditor uses advanced knowledge of billing, coding, auditing, documentation requirements, and charge capture to solve complex charging scenarios, provide education and assistance to operational departments, support fellow team members, and develop processes/procedures to ensure accurate and timely capture of all chargeable procedures.
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Knowledge of physician and hospital billing practices, CMS regulations, CPT coding guidelines from the American Medical Association, DRG methodology, as well as knowledge of the AHA Coding Clinic, commercial payer guidelines, state and federal healthcare regulatory guidance and the ability to research and analyze this information within the structure of a healthcare audit.
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Supports the billing department with: CPT coding and billing reimbursement advice and assistance, government and commercial payer inquiries, internal audits, prepayment reviews and recoupments, management of 3rd party billing and coding audits, monitoring and analyzing trends in claim submissions to identify payment inconsistencies or errors and the corresponding corrective actions, and identification of areas where training and education are needed.
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The Billing and Coding Specialist II will review claims data to ensure the assigned procedural and diagnosis codes meet required legal and insurance rules. Knowledge of medical terminology and coding, including, ICD-10, CPT and HCPCS required.
$24 - $35 an hourFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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2+ years of experience within hospital billing/claims processing, revenue cycle operations, revenue metrics and analytics, and revenue management or consulting experience. Working knowledge of CPT-4, HCPCS, Revenue Codes, and ICD-10 CM.
$70,000 - $100,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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As a Healthcare Content Analyst, you'll research and interpret CMS, CPT/AMA and other major payer policies based on healthcare correct coding and regulatory requirements. If you describe yourself as a healthcare coding and billing policy geek who is passionate about payment accuracy and integrity, then this is the dream job you've been looking for.
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Familiarity with CPT, HCPCS, ICD-10 coding, revenue codes, and hospital billing/claims processing. Five or more years of experience in revenue/accounts receivable financial analysis, claims or billing analysis, decision support, or economics in a healthcare setting.
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This Coding Auditor or Educator is responsible for monitoring compliance with applicable clinical documentation to support coding and billing regulations to ensure appropriate reimbursement for services across all practices/units (acute and ambulatory settings) to include review of accurate and timely assignment of ICD-10 CM/PCS, HCPCS/CPT codes.
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At least 2 years of CPT / HCPCS and ICD-10 coding experience and medical terminology is required. Knowledge of IV drug administration coding and billing is a plus. At least 2 years medical coding and/or billing background.
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Experience with analyzing and/or auditing Revenue Cycle functions; including, but not limited to, ICD-10, CPT, and HCPCS coding accuracy, Medicare policy requirements, and any other operational workflows affecting billing accuracy for hospital or physician claims.
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Provides or coordinates training (based on employee work location and job description) related to the registration of patients into various systems, order entry of requisitions into the LIS, collection of billing information, time of service payments, kit draws, ABNs, and specimen processing, transport, storage, and documentation requirements.
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3+ years of experience in reimbursement, billing and coding within the healthcare, biotechnology, pharmaceutical, wound care or surgical device fields. Proficiency in other disciplines, i.e. ICD-10 & CPT Coding, medical insurance claim forms, EOBs and investigating/resolving claim denials Material & Equipment Used & Frequency.
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