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Job Objective: A brief overview of the position.
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This position is responsible for the review, update or entry of charges to the EPIC PB/HB billing system. Updates are based on LCD, NCCI and MUE edits contained within the EPIC system to reduce denials and produce clean claims
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Reports to
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The Manager or Supervisor of Coding and Charge Capture
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Supervises
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N/A
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Ages of Patients
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N/A
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Blood Borne Pathogens
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Minimal/ No Potential
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Qualifications
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Education
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Required: High School diploma or GED
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Preferred: Degree or some college
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Licensure/Certification
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Preferred: Non APC coding certificate
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Experience
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Required : 1 to 3 years in a clinic or hospital environment
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Preferred: 3 to 5 years of medical billing experience with extensive knowledge in Physician and clinical based billing
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Essential Responsibilities
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Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
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Reviews assigned charge capture work queue daily including but not limited to:
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Filtering on priority based on high dollar and date of service
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Matching E & M services to procedures
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Validation of Bill area, Service provider and billing provider
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Validation of New verses established patient
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Validation of NDC numbers, proper quantity and administration code
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Updates or validates date of injury as indicated.
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Reviews documentation to ensure charge opportunities have not been missed.
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Enters comment as indicated on each encounter touched.
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Defers any encounter with a comment that requires coder or management review.
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Updates insurance as indicated including running a current verification.
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Maintains productivity standards per departmental policy.
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Maintains encounter turnaround time to at or below three days .
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Identifies and reports any system issues or provider trends affecting the charge capture process.
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Attends coder continuing education and departmental meetings as instructed.
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Enters and reconciles any manual batches as assigned.
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Demonstrates team support by completing training in other positions and assisting as needed.
- Performs other duties as assigned.
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Located in the heart of the Coachella Valley, you have access to resort-style living and world-class amenities throughout Southern California.
