Medical Billing

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Oversees monthly billing of outside client accounts as documented in Reference Lab billing; requests for new billing codes from Revenue Cycle as
  
• Monitors annual performance appraisals as assigned
  
• Manages the administration and maintenance of department record keeping systems, including highly sensitive and/or critical administrative and financial
  
• Monitors budget and expense reports including workload and revenue analysis and completes monthly variance analysis for
  
• Participates in administration of departmental fellowship and/or residency programs, training grants and related
  
• Act as backup and assistant to Finance Director with regard to granting submissions and coverage of duties as
  
• Excellent analytical skills necessary to resolve problems requiring a professional level of knowledge in a specific discipline and to improve, enhance or upgrade complex systems and
  
• Excellent communication skills (written as well as verbal) and the ability to work collaboratively with other
  
• Strong diplomatic skills and the ability to effectively deal with conflicting views or issues and mediate fair and workable
  
• Ability to work independently and use skills of judgment and inquiry to consistently support and advance overall programmatic and hospital goals and initiatives
  
• Collects all necessary information for proper charge entry and billing; reconciles data that goes across the interface in billing batches, CPT Codes or corrects missing/incorrect elements to submit electronic
  
• Compiles billing chutes daily (M-F) Hospital Billing (HB), Professional Billing (PB), Prof and No Charge (NC).
  
• Fixes any errors in chutes prior to sending to
  
• Reviews professional billing report to ensure that all services are properly documented within the
  
• Obtains addendum reports from pathologists for any outstanding charges not
  
• Correct name changes, sex, and DOB s on all mismatched accessions and add account information in CoPath (LIS) for Pathology and Cytology lab
  
• After correction of acct/name changes Resend accessions to
  
• Ensure all Upham s Corner Health Center and South Boston Health Center cases are
  
• Register and bill all Professional
  
• Provide overview of Technical Component billing as
  
• Collect CP billing charge slips from
  
• Ensure information is complete and signed by
  
• Obtain account numbers and diagnosis codes on all CP billing that is done manually in the lab (Hematology, Chemistry, Blood Bank charges).
  
• Send in batches to
  
• Collect credit card payments for out-of-state Amyloid
  
• Add all charges/tests for Amyloid testing (consults and genetic blood tests) Assign CPT codes to pathology and cytology
  
• Ensure all pathology/cytology cases are billed accurately and documented to reflect all charges
  
• Review and ensure all charges are captured within the Pathology Information
  
• May compare data to EPIC reports to ensure all CPT codes are in EPIC and volume is crossing s
  
• Manage edits and denials on professional billing working closely with the Professional Billing Office (PBO) and Change Healthcare (CHC).
  
• Respond to professional coder CHC queries on clinical diagnosis, dates of service,
  
• Manage multiple EPIC work-queues (WQs) for claim edits, incomplete information, and
  
• Work Interface errors within EPIC Maintain Billing Fee Code dictionary in CoPath, add CPT s for new tests and set up fee schedule in CoPath with assistance from
  
• Manage yearly CPT code additions/changes/update for relevancy within
  
• Ensure only technical charges are billed for Skin biopsy if needed register patients in EPIC for
  
• Registration in EPIC of all out of state Neuro pathology
  
• Review all VA cases accessioned in the LIS to ensure correct accessioning, correctly ensure the patients are registered in EPIC with the VA s address and forward all information to the Senior Accountant to generate invoices
  
• Answer billing inquiries from physicians and
  
• Maintain cooperative working relationships with all customers (including patients and outside contacts) and respond to requests for information in a prompt and courteous
  
• Conforms to hospital standards of performance and conduct, including those pertaining to patient rights, so that the best possible customer service and patient care may be
  
• Utilizes hospital s behavioral standards as the basis for decision making and to facilitate the department and the hospital s goals and
  
• Follows established hospital infection control and safety
  
• Performs other duties as required
  
• Adheres to all of BMC s RESPECT behavioral standards
  

Requirements

EDUCATION:

• BS/BA degree in business administration, health care administration, accounting or closely ;
  
• Advanced degree (MBA, MHA) is
  
• A minimum of 3 years of relevant experience to include knowledge of anatomy or an equivalent combination of education and
  

KNOWLEDGE AND SKILLS:

• Excellent analytical skills necessary to resolve problems requiring a professional level of knowledge in a specific discipline and to improve, enhance or upgrade complex systems and
  
• Excellent communication skills (written as well as verbal) and the ability to work collaboratively with other
  
• Ability to effectively manage the employees within assigned department and to persuade and negotiate with peer level managers on issues and programs that impact the
  
• Strong diplomatic skills and the ability to effectively deal with conflicting views or issues and mediate fair and workable
  
• Ability to work independently and use skills of judgment and inquiry to consistently support and advance overall programmatic and hospital goals and initiatives
  
• Knowledge of ICD-10
  
• Knowledge of CPT codes 80047-89999+
  

Benefits