Overview:
This position is responsible for designating appropriate ICD-10 and CPT Codes for specialty focused professional billing in Radiation Oncology at Sentara Virginia Beach General Hospital (SVBGH) as well as patient registration and charge entry of the same.
Assist in auditing provider documentation of consultations, re-evaluations and follow up visits at SVBGH facility to ensure documentation justifies level of code capture for professional billing.
Assist with Sentara Norfolk General (SNG) and Sentara Obici (SOH) Specialty focused professional billing on a daily basis with patient registration and preparation.
Assist in physician education when needed.
Responsibilities:
Performs charge capture of both evaluation & management codes and specialty procedure codes in a timely and consistent manner for both outpatient and inpatient services.
Each electronic medical chart is reviewed for content with emphasis on medical history, physician exam, medical decision making and procedure documentation.
Monitor adherence to compliance requirements for electronic signatures in electronic health record.
Review of medical record and assign the appropriate CPT & ICD-10 codes based upon the physician’s dictation and medical documentation to ensure that the most accurate codes are used to reflect the level of service provided to each patient.
Documentation is available through the Radiation Oncology electronic health record (Mosaiq/Aria) and Sentara EPIC system.
Enter daily inpatient and outpatient charges into patient billing record in Allscripts (Touchworks)/Epic Billing Systems adhering to carrier regulations regarding modifier, date sequencing, bundling, etc.
, for claim processing by EVMS Medical Group.
Communicate with management on suggestions relating to areas of improvement for provider documentation, coding improvement and compliance.
Conduct coding/documentation education sessions for providers when needed.
Ensure proper referral and insurance authorization is obtained for patients at SVBGH and scanned into EVMS Medical Group scan database.
Responsible for staying current on insurance carrier regulation changes and communicating changes to management.
Ensure that all patient information, to include insurance information, patient identification and demographics, is properly registered in the IDX system and scanned into the EVMS Medical Group scan database for SVBGH and SNG within 48 hours of the patient’s date of service.
Research and respond to requests from EVMS Medical Group for supporting documentation to appeal denied claims.
Process requests for disability determination and other insurance related matters as requested.
Assist in coordination of internal and external professional billing audits at all Radiation Oncology centers as requested.
Communicates with patients regarding fees, insurance authorizations as well as provide assistance on all insurance related matters.
Prepare and distribute to the physician(s) all documentation needed in time for review and in preparation and participation of the designated Cancer Conference Tumor Boards as requested.
Retrieve EVMS Radiation Oncology mail from mail room as requested.
Process and distribute mail to physicians and office staff.
Serve as a liaison with EVMS Medical Group, Sentara clinical staff and other administrative staff within EVMS.
Performs other duties as assigned
Qualifications:
Associates degree plus 6 years’ experience working with CPT/ ICD-9 & ICD 10 coding and a comprehensive understanding of all insurance types and requirements.
Knowledge of CMS guidelines and National Correct Coding Policy.
Customer service experience in a clinical setting.
Current CPC certification is required and must be maintained annually.
Radiation Oncology Coding Certificate (ROCC) certification is a plus.
TECHNOLOGY/SOFTWARE:
Microsoft Office XP Professional (ACCESS) & Outlook
Mosaiq/Aria Electronic Health Record
Epic/IDX Billing System
Location : Location: US-VA-Norfolk
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