- Comprehensive and generous health, dental and vision benefits
- Up to 19 days of PTO, 2 mental health days and 9 paid holidays your first year (pro-rated for part-time)
- Company-paid life insurance, short-term disability, and long-term disability
- Student loan payment assistance and extensive training
- An incredible team approach that is dynamic and collaborative
- Supply financial application enhancements and modifications as needed to meet internal or external requirements.
- Evaluate coding and billing practices to ensure that appropriate billing and coding practices are being utilized.
- Present findings and feedback in a positive, helpful manner to appropriate parties, and moreover, they should provide pertinent education or guidance to improve the billing and coding procedures.
- Responsible for being current and knowledgeable of billing, coding, and documentation guidelines from the Centers for Medicare and Medicaid Services and other payors.
- Develops, implements, and ongoing maintenance of Electronic Data Interchange (EDI) transactions, including HIPAA 837 claim, 835 remit, 270/271 eligibility inquiry and response, 276/277 claims status inquiry and response, and 278 referral/prior authorization transactions.
- Ensure exchanges are smooth between healthcare systems and external partners. In addition, the researcher will ensure that the appropriate verification, authorization, and HIPAA transaction protocols are in place.
- Assist with configuration, testing, implementation, and monitoring project plans to determine the readiness of conducting the 837i, 837p, 270/271, 835, etc.
- Analyze and understanding implementation guidelines/specifications for both batch and real time of all HIPAA, CMS Forms (specifically UB-04 and CMS
- Troubleshoot issues related to EDI/HIPAA transactions and coordinate resolution with IS Team, EHR Systems (Credible preferred) and the payers.
- Knowledgeable with 837 electronic claims submission and 835 electronic remittance transactions.
- Maintain comprehensive knowledge in advanced report design, including Dashboards with a primary focus on documentation compliance and KPIs. Use of Data Analytics to query, analyze trends, and report meaningful information to substantiate and aid in the provision of quality care. Requires competency in a multitude of platforms, Crystal Reports, Power BI, Credible BI (preferred), Excel, SQL Reporting Services (SSRS) and Management Studio
- Maintain comprehensive knowledge of the SERI, Washington State Data Dictionary, and any other state and federal mandates related to the Electronic Health Record, data, and reporting to maintain and configure the software, keeping workflow in compliance with guidelines.
- Contribute to the efficient operation of all units supported by applying systems analysis techniques to application workflow development. Analyze and collaborate with end users to recommend technical optimization. Research, define, and document systems as needed and design specifications for application development. Supply application enhancements and modifications as needed to meet internal or external requirements.
- Project management and documentation of all System Changes and New Configurations and delegation of duties.
- Provide accurate documentation and operator training as required during application implementation or enhancement, as well as ongoing technical support when required.
- Maintain knowledge of IS-supported software, be familiar with operations utilizing the software, and provide technical support. Trouble-shoot software problems and communicate with vendors regarding application needs, problems, and resolutions.
- Provide technical assistance in maintenance tasks, system security, and file management on the KMHS network.
- Provide technical support in purchasing and using new computer hardware and software. Test and evaluate new software packages.
- Provide backup coverage for the I.S. Manager as requested.
- In addition to the above, any other responsibilities appropriate to the position and not specifically listed in the job description.
- Must have comprehensive experience in professional, outpatient, and inpatient facility coding from a coding, billing, and compliance perspective.
- The individual should be well-versed in billing integrity monitoring by the Washington Service Encounter Reporting Instruction (SERI) guide.
- Working knowledge of HIPAA/HITECH.
- Must possess excellent written and verbal communication skills.
- Need superior customer service skills, being able to work effectively with a variety of people in all departments to determine their problems and find solutions.
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