Emergency Medicine Billing Specialist

Position Summary

This position leads in development, analysis, preparation, and implementation of strategic and operational plans to optimize effectiveness of Department of Emergency Medicine/BUMG revenue cycle systems and operational performance.

Core Functions

• Analyzes, designs, and implements efficient system of processing emergency department Point of Care Ultrasound (POCUS) coding and billing for both facility and professional services.
• Serves as liaison between emergency department and the College of Medicine leadership.
• Serves as a subject matter expert in emergency medicine coding and billing.
• Manages on-going quality assurance efforts to ensure accuracy and compliance with coding and billing best practices and standards.
• Reviews the daily coding hold list returned by specialty third party coders, takes action to resolve, clarify and correct complex billing issues or anomalies to support timely reimbursement deadlines.
• Resolves billing issues such as duplicate charges, missing charges unbillable charts.
• Acts as a liaison between providers and specialty third party coding group leadership regarding all issues of coding work flow including reconciling visits seen versus charged, documentation requirements and any items requiring resolution to support timely processing.
• Develops and implements a system to on-board and conduct regular educational sessions with all emergency department providers regarding compliant documentation and coding.
• Acts as a revenue cycle operational consultant with expertise in emergency medicine documentation and coding to continually educate and give feedback to Faculty Physicians regarding effective practices to capture RVU’s for services rendered.
• Identifies and works with outlier physicians to improve their RVU capture
• Produces regular reports with analysis of coding queues and reconciliation of visits seen versus billed and follow up with all providers regarding incomplete charts or charts completed but not sent for coding and billing.
• Acts as a knowledge resource to clinical staff for billing code issues.

Minimum Qualifications

• High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a related health care field.
• Must demonstrate an elevated level of knowledge and understanding of ICD10 and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as required for the assigned practice areas.
• Requires three or more years of specialized professional coding experience for clinical specialty areas.
• Must be able to achieve an acceptable accuracy rate on the coding test administered by the hiring business unit according to pre-established company standards.
• Requires the ability to work autonomously while maintaining a high level of accountability and quality performance outcomes.
• Must demonstrate excellent critical thinking and organization skills.
• Must be able to work effectively with common office software, coding software, and abstracting systems.

Preferred Qualifications

• Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) credentials are preferred.
• Medical Coding Specialty Credential from the American Academy of Professional Coders (AAPC) in the assigned specialty areas are a plus.
• Specialty coding certification.