MD Anderson Cancer Center Regional Billing Specialist - RCC Administration in Houston, Texas
This position requires travel at least one day a week to one of the Houston Area Locations: West Houston, The Woodlands, Sugar Land, or League City.
Provides support to the charge capture and reconciliation process for professional and technical charges for the Houston Area Locations (HAL's) and the Houston Screening Network (HSN). Impacts revenue throughout the HAL's.
Ideal candidate will have experience abstracting medical codes from documentation; experience using Epic EHR, and will have a coding certification with AAPC or AHIMA.
Develops implements and monitors processes to ensure all professional and/or technical charges are appropriately captured. Validates patient and financial information during patient registrations and determines patient financial eligibility. Completes charge entry process. Assists team with HSN self-pay patient monitoring and the surgery audit-tracking tool. Assists with collecting and summarizing data related to special projects.
Charge Capture and Reconciliation for Houston Area Locations:
Responsible for Professional and Hospital charge capture submission and reconciliation daily for multiple specialties to ensure accurate and timeliness of revenue charge capture according to institutional policy for CPT, HCPCS and ICD-10 code selections. Maintain ongoing education of coding and billing changes.Review of documentation with a good understanding of anatomy and medical terminology according to coding and documentation guidelines.
Reconcile procedure logs for accurate charge submission for all services and supplies, and identify and resolve issues impeding charge capture. Review recovery patient types, recovery times, and audit patient accounts to ensure appropriate billing and correct cost center allocation. Review and resolve work queue edits in Epic and any other documentation and billing software to ensure all charges are captured and dropped in a timely manner. Ensure accuracy of the Essential Data Elements for services rendered to each patient. Communicate inaccuracies for resolution and corrective action. Communicate any inaccuracies or challenges identified immediately to the Manager which exist in creating barriers to meet institutional policy. Assist with analysis of Charge Description Master and maintenance to identify new supplies and ensure accuracy of charge entry on an on-going basis.
Ambulatory Treatment Center Billing:
Review ATC center's daily schedule to confirm all patients have been appropriately arrived or cancelled. Audit each patient's medical record for documentation for each encounter. Notify nursing staff of any missing or incomplete documentation. Abstract appropriate charges including, but not limited to administration and chemotherapy infusions and injections. Reconcile charges to schedule for complete charge entry. Assists with collection, analyzing data and maintain records of charges. Assists in reviewing billing system edits. Determine corrective action and make necessary updates to resolve edits for appropriate billing of claims.
Surgery Reconciliation Tracking Tool:
Perform daily arrival of scheduled offsite surgeries in OneConnect.
Enter cases from OneConnect offsite surgery report into the Surgery Tracking Tool including financial information and total charges. Notify physician by email of incomplete documentation according to departmental and institutional policy.
Assist in follow up on cases for insurance payment documentation. Provide review of denied claims including first level appeal with insurance companies.
When needed, provide copies of reports from outside facilities to surgery coders, PBS associates and insurance company representatives.
Required: Associate's degree in Business Administration or related field.
Required: Four years of professional fee billing experience in healthcare or insurance field. May substitute required education degree with additional years of experience on a one to one basis.
Preferred: Experience abstracting medical codes from documentation; EPIC experience.
Preferred: Certified Professional Coder (CPC) issued by the American Academy of Professional Coders or AHIMA certification.
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html
Requisition ID: 130598
Employment Status: Full-Time
Employee Status: Regular
FLSA: exempt and not eligible for overtime pay
Work Week: Days
Fund Type: Hard
Pivotal Position: Yes
Minimum Salary: US Dollar (USD) 44,000
Midpoint Salary: US Dollar (USD) 55,000
Maximum Salary : US Dollar (USD) 66,000