Coder/Charge Entry Specialist

Job Details

Entry

MMR State Street - Saginaw, MI

Full Time

Summary

Supervisory Responsibilities: None

Objective: The Coder/Charge Entry Specialist determines appropriate payer, charges, diagnosis and other information necessary to accurately bill for services.

Essential Duties:

Know and support the Mission Statement, Policy/Procedures and standards of MMR.

Review dispatch information and patient care reports along with other documents to accurately determine service type, level, diagnosis, medical necessity, charges and payer, for assigned days (even/odd).

Code the patient diagnosis code utilizing the ICD10 coding system.

Select the correct HPPCS code.

Understand proficiently Tier 1/Tier 2, ALS 1 with and w/o ProQA/EMD) ALS 2, SCT/Neonate/Emergency and non-emergency transports and how these assist in determining the charges.

Understand proficiently EMT-Basic, EMT-Paramedic, Specialty Care Transport (SCT) trained staff.

Complete narrative and ambulance certification areas.

Places claim in appropriate schedule i.e., Auto 1/Neonate 1/Care/Caid, etc.

Verify the claim.

Maintains HIPAA compliance.

Perform and assist with other duties as assigned.

Knowledge, Skill and Competency Requirements:

Two or more years of medical billing experience including appeals resolution

Must be well versed in daily operations as it pertains to the ambulance industry and operations

Must proficiently use insurance websites i.e., C-Snap, Champs, Web Denis, etc., 2 months after date of hire

Reading skills to comprehend correspondence and materials specific to the healthcare industry

Writing skills to compose complex correspondence or reports with minimal direction provided

Must demonstrate ability to maintain security and confidentiality with utmost discretion

Ability to communicate effectively both verbally and in writing, in the English language

Ability to organize tasks and insure timely completion of all projects

Advanced computer skills including the ability to utilize a computer PC with Windows operating system

Ability to operate office equipment, including but not limited to, copier, fax machine, scanner, monitor, multi-line telephone, printer, and calculator

Proficiency with Microsoft Word and Excel

Regular attendance and timeliness

Skilled in typing, data entry, scanning, electronic filing and document retrieval

High School Diploma

Must be at least 18 years old

Physical Factors: Suitable dexterity to operate standard office equipment. Capability to stand or sit for extended periods of time.

Working Conditions/Environment: Most work is done in a typical office setting with daily exposure in all other department areas. Regular, in-person attendance is an essential function of the job. Materials and equipment used include desktop computer, telephone, fax, copier, printer and other standard office equipment. Hours must be flexible to meet the demands of the office.