Coord, Billing And Coding

Position Title: Coord, Billing and Coding Department: Cancer Center Admin

Purpose:

Responsible for day-to-day administrative functions not limited to: business operations, patient billing, prescription card through-put, accounting functions and medical record maintenance.

Primary responsibility for the enrollment of infusion patients into a prescription card program.

This includes but is not limited to: personal one-on-one application completion, submission of applications and claims to drug companies and tracking patient encounters for qualifying events. Will assist with obtaining and documenting patients# insurance coverage and precertification or authorization requirements.

Will assist with collection of co-payments and deductibles, conduct follow-up on accounts, as well as verify and document insurance coverage for patients served through the service to include the charge masters.

Will assist with follow-up of any/all billing inquiries in conjunction with the GHS Financial Services Department(s). Assigns CPT codes to infusions and procedures for billing and financial purposes. Will have knowledge of medical record documentation to support system-wide accurate coding, billing and compliance by external regulatory agencies. Will ensure all activities support the philosophies and standards of Genesis Health System with respect to all applicable pillars.

Report To:

Manager, Cancer Center

Supervisory Responsibility:

Guidance: The job requires the provision of occasional guidance and training to others. The job does not have formal or official supervisory responsibilities.

Materials Responsibility:

Very Limited.

Work requires very limited responsibility for material resources.

Examples of resources could include personal work materials, supplies or equipment, or very small amounts of cash. The employee has a very limited or indirect amount of control over these resources.

Although human error might require the repair or replacement of materials, usually the cost of correcting these errors is minor.

The variety and volume of resources is also very limited. Problems associated with material resources are very uncomplicated.

Key Relationship:

Co-workers/Health System Employees, Governing Boards, Physicians/Medical Office Staff, Third Party Payors/Insurance Companies # POSITION SPECIFICATION # Education: 2 year college program or equivalent experience

Field Of Study:

Business, Finance, Health Information Management, or related field

Special Training:

Experience with and knowledge of but not limited to:

Billing, A/R, insurance verification, ICD and CPT coding, revenue cycle, and charge capture. Medical terminology knowledge.

Training Preferred:

Coding experience. Knowledge of and experience using local/national coverage determinations. # Licensure/Registration: # Experience: More than 2 years experience required.

Interpersonal Skills:

Interaction is with a variety of people inside or outside the organization.

Communications are of moderate difficulty and sensitivity.

Contact with others may involve detailed # lengthy dialogues # exchanges of information. Requires a moderate amount of interpersonal skills. Interactions involve dealing with moderately complicated problem situations or stressful encounters.

Working Conditions:

There is very limited exposure to adverse environmental conditions.

Some undesirable or unpleasant environmental characteristics may occur but the physical environment is generally safe and there is minimal health risk.

No safety equipment or unusual precautions are required. The amount of time the employee may experience these minor adverse conditions would be limited to 10% or less of the work day.

Possible Exposure to Blood Borne Pathogens:

None

Miscellaneous:

Position Title: Coord, Billing and Coding

Department: Cancer Center Admin

Purpose: Responsible for day-to-day administrative functions not limited to: business operations, patient billing, prescription card through-put, accounting functions and medical record maintenance.

Primary responsibility for the enrollment of infusion patients into a prescription card program.

This includes but is not limited to: personal one-on-one application completion, submission of applications and claims to drug companies and tracking patient encounters for qualifying events. Will assist with obtaining and documenting patients' insurance coverage and precertification or authorization requirements.

Will assist with collection of co-payments and deductibles, conduct follow-up on accounts, as well as verify and document insurance coverage for patients served through the service to include the charge masters.

Will assist with follow-up of any/all billing inquiries in conjunction with the GHS Financial Services Department(s). Assigns CPT codes to infusions and procedures for billing and financial purposes. Will have knowledge of medical record documentation to support system-wide accurate coding, billing and compliance by external regulatory agencies. Will ensure all activities support the philosophies and standards of Genesis Health System with respect to all applicable pillars.

Report To: Manager, Cancer Center

Supervisory Responsibility: Guidance: The job requires the provision of occasional guidance and training to others. The job does not have formal or official supervisory responsibilities.

Materials Responsibility: Very Limited.

Work requires very limited responsibility for material resources.

Examples of resources could include personal work materials, supplies or equipment, or very small amounts of cash. The employee has a very limited or indirect amount of control over these resources.

Although human error might require the repair or replacement of materials, usually the cost of correcting these errors is minor.

The variety and volume of resources is also very limited. Problems associated with material resources are very uncomplicated.

Key Relationship: Co-workers/Health System Employees, Governing Boards, Physicians/Medical Office Staff, Third Party Payors/Insurance Companies

POSITION SPECIFICATION

Education: 2 year college program or equivalent experience

Field Of Study: Business, Finance, Health Information Management, or related field

Special Training: Experience with and knowledge of but not limited to:

Billing, A/R, insurance verification, ICD and CPT coding, revenue cycle, and charge capture. Medical terminology knowledge.

Training Preferred: Coding experience. Knowledge of and experience using local/national coverage determinations.

Licensure/Registration:

Experience: More than 2 years experience required.

Interpersonal Skills: Interaction is with a variety of people inside or outside the organization.

Communications are of moderate difficulty and sensitivity.

Contact with others may involve detailed & lengthy dialogues & exchanges of information. Requires a moderate amount of interpersonal skills. Interactions involve dealing with moderately complicated problem situations or stressful encounters.

Working Conditions: There is very limited exposure to adverse environmental conditions.

Some undesirable or unpleasant environmental characteristics may occur but the physical environment is generally safe and there is minimal health risk.

No safety equipment or unusual precautions are required. The amount of time the employee may experience these minor adverse conditions would be limited to 10% or less of the work day.

Possible Exposure to Blood Borne Pathogens: None

Miscellaneous: