The Billing and Coding Specialist is responsible for accurate patient registration information, performing and obtaining payer financial coverage verification, service approvals, and utilization requirements and provides assistance in the areas of both Medical Billing and Coding. Performs accurate daily processing of all coding and/or claims output, meeting agency/payor transmission deadlines.Assigns appropriate revenue, procedure, and diagnosis codes after thorough review of medical records, clinical visit notes, and resource materials. Acts as a resource for team members as wells a clinical staff ensuring coding practices fall within established compliance guidelines for ICD-9, ICD-10 and CPT codes. Processes all phases of the revenue cycle. Reviews demographic information, codes, charges, and corrects claims to meet specific payer requirements. Use critical thinking skills to bill services compliantly and question areas of uncertainty. Obtains authorizations for services in accordance with payor contracts and regulatory guidelines and effectively communicates these authorizations with applicable staff. Accurately enters data for billing to be generated as well as effectively utilizes computer software programs for encoding. Analyzes and performs efficient pre-billing audits, account activity research, identifies solutions, and initiates an appropriate course of action; documents actions and notes in the EMR as appropriate. Works with payors/patients to review denials, assure proper billing requirements, and initiate changes as needed.
QUALIFICATIONS AND REQUIREMENTS
Education: High School diploma or equivalent required. Post high school education and training in ICD-9/ICD-10 and/or CPT coding required. Associate and/or Bachelors degree in related field preferred. Education may be substituted depending on experience.
Experience: Experience in a medical billing and/or coding in an outpatient setting preferred.
Licenses/Certificates/Registration: CPC, CAA Preferred.
Level of Business Knowledge/Knowledge/Skills/Abilities: Medical terminology/clerical/customer service experience required. Understanding of ICD 9, ICD 10 and CPT codes preferred.
Virginia Mason Memorial, part of the Virginia Mason Health System, is made up of a 226-bed hospital as well as 20+ primary care and specialty care practices/services. We are a nonprofit community hospital that has served Central Washington s Yakima valley for more than 60 years. We are seeking remarkable employees with a passion for patients and customer service to add to our growing team!
We offer a three tier benefit plan including medical, dental, vision coverage, plus a generous 401K plan (with matching!), life insurance options, competitive compensation, an employee wellness clinic and leadership development and education.
Why do we do what we do? As the regions leading health care provider and Yakimas largest employer, we believe that by improving health, we can transform Yakima! Our vision is to create healthy communities one person at a time. This means that each member of our award-winning team works to provide our patients, and their families, with the best medical and individual care possible. We work together to demonstrate our values of Respect, Accountability, Teamwork, Stewardship, and Innovation for everyone who walks through our doors, patients and coworkers alike. We would love to hear from you!
Virginia Mason Memorial provides reasonable accommodations to assist qualified individuals in order to perform the essential duties/requirements their job requires. The description is intended to provide only basic guidelines for meeting job requirements and serves as merely a summary rather than a complete listing of duties. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve. This job description does not constitute a contract as employment is at will.
Buffalo Wild Wings | Wingmen V, LLC (Pacific Bells) - Union Gap, WA
The Bracken Group - Yakima, WA
State of Washington Dept. of Corrections - Yakima, WA
Carter's | OshKosh B'gosh Retail - Union Gap, WA
Copiers Northwest Inc - Yakima, WA