Employment Type:

Full time

Shift:

Day Shift

Description:

Trinity Health Of New England Medical Group is looking for a Certified Coder & Reimbursement Specialist to join a mission-driven healthcare team. Our vision is to provide state-of-the-art healthcare to those within our local communities, creating a positive impact for each individual that walks through our doors.

This person is responsible to the Business Office Supervisor, and ultimately, to the Business Manager of SFMG to ensure that all billable medical services provided are coded accurately and properly submitted for billing. Plays an active part in obtaining reimbursement from third party payers; functions as a steward of SFMG’s resources. The incumbent accomplishes these duties based on a current, comprehensive working knowledge of anatomy and physiology of specialty area billed, of CPT, ICD-9, HCPCS coding, of modifiers, of all things related to physician coding, insurance, and reimbursement. Keeps knowledge base current through a variety of methodologies.

Top Reasons to Work at Trinity Health of New England:

• Great benefits start on date of hire
• Competitive pay
• Mission-Driven Team Environment

Work Hours/Shift:

• Day Shift.

You Will Be Responsible For:

• Pre-Accounts Receivable (A/R) Coding Review: Efficiently analyze insurance claims independently before submission; to submit claims with accurate coding and in a timely fashion to ensure optimum reimbursement and compliance while meeting established performance standard levels. Utilize payer and coding specific websites to maintain up-to-date coding knowledge, including new changes to coding compliance and reimbursement. Effectively provide correct coding education and feedback to all providers, clinical staff, and other business staff with regards to payer policy and regulations that impact workflows, revenue, and compliance; this includes written, verbal, and electronic communications. Identify incorrect coding and compliance trends; to analyze and investigate suspected problems; and to forward problems to the attention of the Coding Supervisor in a timely manner
• Claim Denial Review: Independently research and accurately resolve insurance denials in a timely fashion and with moderate supervision. Notify PNO Coding Supervisor of denial trends and changes needed within Epic to eliminate the errors. Provide detailed information on providers that need to be audited to the audit department in a timely manner. Address internal and external customer inquiries in a professional manner and resolve issues in a timely manner.
• Communication/Investigation: Utilizing Payer and coding websites, stay up to date on coding issues, coding changes, or other issues that affect compliance and reimbursement, and share appropriately with the rest of the coding staff. Effectively integrate coding/billing changes through the proper channels; changes in workflow and revenue issues must be forwarded to the attention of the PNO Coding Supervisor. Demonstrate excellent communication skills both verbally and written/electronic when dealing with either business or clinical staff (e.g., provider questions, coding feedback); effective listening techniques. Demonstrate the ability to quickly identify and investigate possible coding compliance issues and trends; perform thorough and complete investigation and report any significant findings to the attention of the PNO Coding Supervisor in a timely fashion. Become proficient in working with the Epic system, including the Charge Review and Follow-up Insurance Work Queues. Efficiently analyze medical record documentation to ensure accuracy of coding and billing procedures.

Requirements:

• Education: Successful completion of coursework in anatomy & physiology, CPT, ICD, and HCPCS coding.
• Experience: Three years in a medical office environment doing physician billing and physician coding.
• Excellent organization skills. Comprehensive knowledge of physician coding and reimbursement. Computer experience necessary. Ability to adequately use the department’s computerized system and its associated devices. Ability to assist in redesigning superbills and/or function fluently within the electronic medical record system, including offering feedback to providers.

About Trinity Health Of New England:

Trinity Health Of New England is an integrated health care delivery system that is comprised of world-class providers and facilities dedicated to full spectrum preventative, acute, and post-acute care. We aim to deliver top-level care to increase our community's overall health at lower costs. While we serve nearly 3 million people, we are proud to be a part of a national system that focuses on putting our patients first and having the best colleagues to do so. 

Trinity Health Of New England benefits include health insurance, adoption assistance, tuition reimbursement, paid vacation, sick time, and professional advancement just to name a few. Employees can also take advantage of extra benefits specific to each hospital.

Step up to your potential. Write your story and apply today!

Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by federal, state or local law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.