Rush-Copley Medical Center Billing Associate/RCMG in Aurora, Illinois
Position Summary The primary responsibilities of this position include coding all diagnoses, office procedures, and surgeries from Physician documentation within the Practice Management System, manually submitted hospital charge sheets, operative reports, and/or pathology reports; as well as resolving all claim edits and pending claims daily.
Primary Customers Patients and their families, physicians, clinical, administrative and practice management staff, representatives from Rush-Copley Medical Group and Copley Memorial Hospital, payers and other outside referral sources.
Performance Behaviors Customer service must be a high priority for each and every person in the practice. In identifying performance behaviors for the practice, the practice reviewed patient satisfaction survey results from surveys conducted by Copley Memorial Hospital. Based on those results, Copley developed performance behaviors for their employees. Those behaviors have been adopted by the practice, and all employees will be evaluated based on their ability to carry out these behaviors.
Treats others with courtesy, respect and caring touch in all interactions.
Goes the extra mile to identify, fulfill and exceed customer needs; puts those needs first.
Promotes patient rights and ensures confidentiality and privacy at all times.
Continuously looks for, suggests and works on better ways to conduct work.
Is open to new ideas and changes; encourages others to do the same.
Plans for change by involving all those whom may be impacted from the start.
Identifies CQI opportunities and participates in CQI initiatives.
Promotes Teamwork and Partnerships
Treats each employee as an equal and valued member of the team; works cooperatively with other employees to complete the work.
Willingly flexes to meet changing workload demands and priorities.
Helps make the practice a great place to work by promoting positives and committing to resolve problems.
Team Relationships Coached by: Coding Supervisor
Position Type Hourly
Key Responsibilities The Coder III will be responsible for the following areas:
Reviews all office encounters and hospital charge sheets for completeness and accuracy daily, based on guidelines identified by the billing office.
CPT and Diagnosis coding for all office visits, procedures, and hospital rounding visits. Compares codes submitted by Physicians and reports coding discrepancies to leadership.
Reviews and codes all office encounters, hospital charges within 48 hours of date of service. Runs reports to confirm all transactions are accurate and completed.
Codes surgical procedures performed by physician by reviewing documentation including but not limited to operative report, pathology report, and physician notes.
Researches the appropriate codes for new services and procedures, works in conjunction with the admin department to add new codes to the system and assign an appropriate price.
Adheres to monthly close timelines and reconciliation procedures as defined by the billing department
Reviews and resolves Claim Edits according to CBO policies and procedures
Provides coding expertise to CBO and Front office staff to address claims and pre-billing questions
Serves as primary liaison to the practice staff for all billing related issues
Willingly presents/attends in-service and educational programs; shares information with team members.
Communicates in ways that demonstrates professionalism, caring and valuing of patients, co-workers, and physicians.
Identifies opportunities for cost savings.
Assists in providing meaningful orientation and ongoing experiences to new staff.
Takes initiative for own learning gaps.
Is aware of own positive and negative biases and limitations.
Submits scheduling requests for PTO, per office guidelines.
Has self-confidence in own expertise.
Follows established CBO policies and guidelines
The above statements are intended to describe the essential job functions and level of work performed by individuals in this position. They are not to be construed as an exhaustive list of all job duties that may be performed.
Education and Previous Experience
High school diploma or equivalent required. Some college preferred.
Minimum of 6 years previous medical billing experience. Experience in similar specialty setting preferred.
Minimum of 6 years previous coding experience preferred. Multi Specialty certification preferred. Orthopedic background highly desired.
AAPC coding certification required, AHIMA certification preferred.
Thorough knowledge of insurance payer requirements and limitations including but not limited to commercial, government, workman’s comp, POS, PPO, HMO plans, and third party payers
Previous experience with practice management/medical billing computer programs required.
Previous EPIC experience preferred.
Previous experience with electronic medical record management system preferred
Previous Microsoft Office Suite (specifically Word and Excel) experience preferred.
Excellent oral/written communication skills.
Excellent organizational skills.
Ability to set priorities, document conversations and specific actions taken and apply appropriate policies and procedures.
Flexible; able to adapt to change.