At WHA, we're a team, passionate about humanizing healthcare. We're inspired by the diverse stories, strength and resilience of our patients and the unique choices they make in pursuing health for themselves and their families. We envision a world where every person has the opportunity to achieve their optimal health and we're here to support that journey with personalized, culturally competent care and knowledge.
The Billing and Coding Specialist II reviews chart notes and validates clinician selected codes and supporting documentation to ensure the assigned procedural and diagnosis codes meet required legal and insurance rules.
This position full time, Mon. through Fri., working 8 hours shifts between the hours of 6 am to 6 pm (PST).
DUTIES
- Validates charges and documentation to ensure billing codes are accurate prior to claims submission. Seeks clarification from provider and/or clinical staff as needed.
- Applies coding (CPT, HCPCS, and ICD-10) and payer specific coding requirements, accurately and, as appropriate.
- Codes for all services performed at WHA, including office visits, wellness exams, in office surgeries & procedures, injections, supplies, lab, ultrasound, screening mammography, behavioral health, maternal fetal medicine, inpatient and outpatient hospital services, and ambulatory surgical center.
- Assists with prior authorization coding and accounts receivable coding denial reviews.
- Adds account notes when a claim has been changed or reviewed.
- Provides feedback to coding or auditing supervisor if there are trends in coding errors.
- Participates in continuing education programs to increase coding knowledge.
- Maintains accuracy and productivity in accordance with WHA's Coding Standards.
- Understands the EPIC Cadence platform and Epic Resolute module, including patient registration and guarantor snapshot.
