Billing Coordinator Sr

Job Details

Job Description

PRIMARY FUNCTION:

This position will be responsible for the management of all complex billing analysis and revenue/billing for the Department of Radiation billing across and professional billingacross TJUH Aria and other JUP locations. Incumbent will insure all federal regulations and policy & procedures are adhered to with respect to auditing billing coding & documentation of compliant medical depth knowledge of clinical operations and front-end patient registration is required. This position will review audit and recommend revisions to department billing policy and procedures as needed.

ESSENTIAL FUNCTIONS:

• Ensures accurate and timely billing of all hospital and professional charges reviews all billing to ensure that charges are consistent with medical necessity documentation; services are rendered and meet all compliance requirements.
• Works with physicians and staff to obtain information required for initial claim submission and for follow-up to edits denials and rejections while managing the charge capture process and quality assurance in working with the Radiation Oncology team.
• Obtains prior authorizations for procedures when needed.
• Manages billing denials. Follows up on each denial to determine if cause was physician related system related or billing error. Eliminate the causes of denials and collect the maximum on each patient account as rapidly as possible.
• Ensures all diagnosis and procedures that may impact the facilitys reimbursement are identified based on accepted diagnostic coding guidelines attested to by the physician sequenced correctly and coded in an accurate and ethical manner for optimum reimbursement.
• Consults with physicians and nurse managers for clarifications of clinical data when encountering conflicting or ambiguous information and/or missing documentation.
• Interacts with co-workers visitors and other staff consistent with the values of Jefferson

OTHER FUNCTIONS AND COMPETENCIES:

• Process billing of daily code captures. Includes coordination of the daily operations and work flow processes while managing billing edits/denials.
• Responsible for working Quality Assurance Check Lists implemented by Physics and Dosimetry staff to insure the accurate collection and capture of charges.
• Adjust work assignments as necessary to keep billing lag to a minimum.
• Daily Charge reconciliation.
• Keep up-to date with Mosaiq /EMR system upgrades that effect workflows related to billing and documentation.
• Respond to telephone inquiries from patients and insurance companies regarding billing coverage criteria coordination of benefits and subscriber eligibility.
• Assist Director with monthly Collection Report.
• Assist Director with developing and implementing procedures to streamline billing process and improve efficiency of process.
• Cover other positions within the department when needed.
• EDUCATIONAL/TRAINING REQUIREMENTS:

• High School diploma or GED required. Associates degree preferred

  CERTIFICATES LICENSES AND REGISTRATION:

  EXPERIENCE REQUIREMENTS:

  5 or more years of experience in the area of billing operations.

  ADDITIONAL INFORMATION:

  Word excel NaviNet EviCore etc. Must have knowledge of CPT and ICD-10 coding. Up-to-date knowledge of third-party rules and regulations. Knowledge of medical terminology.

Work Shift

Worker Sub Type

Employee Entity

Primary Location Address

Nationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

For more benefits information please click here