Position Summary
Under general supervision this position is responsible for ensuring that provider assignment errors are corrected prior to final closing for all Datasets by auditing and analyzing reports of charges to assure appropriate and accurate provider assignment and CPT to place of service assignment.
Essential Duties and Responsibilities
Primary Responsibilities
- Monitors monthly closing schedule to ensure all provider assignment/sequencing reviews are completed 1 day prior to the month-end date
- Run reports for the verification process for each dataset on a weekly or bi-weekly basis.
- Review reports to determine accuracy in provider assignment/sequencing per client or payer guidelines.
- Reviews reports to validate location and POS accuracy of billed services associated with provider assignments.
- Distributes coder trends or quality findings to the appropriate coding workflow team to educate the coder and track accuracy.
- Makes provider assignment and/or sequencing corrections in billing platform or other system(s).
- Participates in company meetings.
- Provides status reports to Operations Manager as requested.
- Complies with all internal policies and procedures.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Knowledge, Skills, & Abilities
- Ability to work at a fast pace and maintain a high concentration level with accuracy working in multiple system platforms.
- Ability to work independently with minimal supervision, to work under pressure, and to work under deadlines.
- Excellent organizational skills.
- Excellent time-management skills.
- Ability to troubleshoot in an electronic environment.
- Computer keyboarding skills and experience with MS Office
Education & Experience Requirements
- Knowledge of coding principles and guidelines, preferred.
- Knowledge of insurance payer guidelines, preferred.
- Strong organizational and interpersonal skills
- Excellent written and oral communication skills.
- Excellent analytical skills
- Proficient in Microsoft Office applications including Word and Excel.
- Ability to prioritize workload, to meet deadlines and to maintain a high level of quality and accuracy
Work Environment/Physical Demands
This role operates in a professional office environment. This role routinely uses standard office equipment such as laptop computers, copiers and line/cell phones.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.