Charge Integrity Coord, Business Development, Full Time, Days

Develops and/or maintains a high level of knowledge and expertise relative to Occupational Health Services billing through the Agility computer information system. The scope of the Charge Integrity Coordinator includes billing to the workers comp insurances as well as direct company client billing, and the follow-up there to including pending, rejections, and rebilling. Additionally, serves as the subject matter expert and act as a resource to the providers, including WellPorte and management regarding appropriateness of codes, interpretation of documentation, medical terminology, and reimbursement.  Provides monthly random audits and share the findings with applicable team members to ensure compliance. 

Education:  

• High School Diplomas or equivalent required
• AS or BS in Health Information Technology preferred.

Certifications/Experience: 

• One of the following certifications must be obtained within 6 months of employment and maintained throughout employment:  RHIA, RHIT, CPC, CCS, or CCA
• Experience in medical coding preferred.  
• Experience in physician office or hospital billing with at least 1 years’ experience in occupational health billing and or medical terminology and coding preferred.
• Knowledgeable in performing calculations on a calculator and/or computer preferred. 
• Knowledge of billing and medical coding for workers comp preferred.
• Maintains a high level of expertise as related to the posting, billing, and collections of company paid services (post-offer exams, drug testing, wellness programs, etc.) as well as billing to workers’ compensation carriers and Third Party Administrators (TPAs) for work-related injury care through the state of Indiana's Workers Compensation program and other group health plans.
• Prepares and processes all necessary coding for each visit through the computer system to expedite insurance follow-up and/or corrects invalid coding information. Contacts supervisor to address any billing/collection issues that may arise.
• Utilizes computerized billing system to prepare and submit appropriate billings to company, carrier or TPA using current payor guidelines and department procedures. Continually follows-up on outstanding accounts through contacts/inquiries to companies, carriers, and/or TPAs to facilitate prompt resolution and/or payment based upon department collection guidelines.
• Provides collections on patient accounts and reviews and maintains patient accounts to keep the balance in a 50-60 day collection/budget status area.
• Receives and posts company, carrier, and/or TPA checks according to established procedures on a daily, weekly, and/or monthly basis as appropriate and prepares/submits appropriate paperwork. Balances checks received against receipts and submits for reconciliation and deposit. Scans checks for deposit to appropriate bank.
• Monitors accounts for payment accuracy and investigates delinquent accounts to identify any special circumstances affecting payment delays, and follows-up with appropriate parties as necessary. Forwards any contract management concerns to the supervisor and recommends disposition (i.e., referral to collection agency or other legal action or write off), if any.
• Responds to all incoming correspondence, insurance and/or patient requests utilizing established guidelines within 48 hours. Processes medical record requests timely, accurately, and according to Northwest Health Occupational Medicine policy and procedures. This includes requests made by client company, insurance carrier, attorney and/or the patient. If necessary, attaches to invoice/billing statement and mails.
• Performs other duties as assigned.
• Attitude - Provides highest quality service and meeting customers' needs with utmost kindness, care, compassion, courtesy, empathy, respect and friendliness. Always acknowledges and serves customers with a friendly, open smile and direct eye contact.
• Appearance - Takes pride in personal appearance, the facility and its surroundings.
• Commitment to Coworkers - Recognizes we are linked to one another by a common purpose; serving our patients and our community, that we are team members with our physicians and co-workers, and that we each deserve respect and support.
• Customer Waiting - Provides prompt service, keeps customers informed regarding the time in which the service will be performed and makes customers comfortable while they are waiting.
• Privacy – Maintains customer privacy and confidentiality
• Responsiveness - Acknowledges every approaching patient or family member. Responds in a way that demonstrates the care, courtesy and respect our customers deserve.
• Safety Awareness - Ensures an accident-free environment. Establishes, promotes and monitors a proactive innovative approach to enhance hospital and patient safety. Adheres to and ensures compliance with Joint commission Patient Safety Goals and hospital safety policies.
• Sense of Ownership - Demonstrates a sense of ownership in their job, takes pride in what they do, and how they do it. Accepts responsibility for and is in control of the job that needs to be done
• Team Member is accountable for areas of responsibility meeting regulatory requirements including but not limited to maintaining annual TB testing, completing annual mandatories (ALC and competency), and maintaining current registration/certification/licensures as appropriate to position requirements.