Job Description

MEDICAL BILLING CODING SPECIALIST  

SITE OF SERVICE:

DOJ (Department of Justice Prison) – Butner, NC

Federal Correctional Complex (FCC) located in Butner, North Carolina at Old NC Highway 75, Butner, NC 27509.

QUALIFICATIONS:

Experience: Possess 2 years of experience in a healthcare or insurance environment

Certification : Must have one of the following certifications:

· Registered Health Information Administrator (RHIA)

· Registered Health Information Technician (RHIT)

· Certified Coding Specialist (CCS)

· Certified Coding Assistant (CCA)

· Certified Professional Coder (CPC)

CORE RESPONSIBILITIES:

· Requires strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient in database software.

· Selected applicant must have a thorough knowledge of Medicare payment principles, to include but not be limited to:

o Medicare Inpatient Prospective Payment System

o Medicare Outpatient Prospective Payment System

o Medicare Ambulatory Surgical Center Payment Rates

o Medicare Part B Physician Fee Schedule

o Medicare Anesthesia Physician Services

o Medicare Clinical Laboratory Fee Schedule

o Medicare Drugs and Biological Payment Amounts

· Utilizing automated records of ingress and egress for each facility at the FCC, the contractor shall verify time worked for other contract staff providing services at the FCC.

· Utilizing Medicare National Correct Coding Initiative (NCCI) coding principles, the selected applicant shall verify that invoices for medical care to inmates provided by contracted medical services providers are coded appropriately based upon the care documented in the inmates’ medical records.

· Utilizing Medicare Part A and Part B payment regulations and payment recommendations from a third party adjudicator, the selected applicant shall verify that invoices for the provision of medical care to inmates which have been determined to have been properly coded are also billed appropriately in accordance with the contracted terms and conditions of the contract under which the medical services were provided.

· Utilizing contracted rates provided by the Government, the selected applicant shall verify that invoices for services performed at the FCC by other contracted medical services providers are accurately billed based upon the inclusion of approved/verified time sheets, the application of correct unit prices to the number of hours billed, and the overall total calculation.

· Utilizing knowledge of Medicare coding and billing standards and procedures, selected applicant shall investigate all inconsistencies in invoices identified by third party adjudicator.

· Other duties will include, but are not limited to filing, composing memoranda, maintaining suspense files, data entry, and preparation of cost analysis, financial obligations reconciliations, budget and expenditures tracking.

HOURS:

The work schedule will be 30 hours per week, five days a week, excluding federal holidays. The schedule will include a ½ hour unpaid lunch break

SPECIAL REQUIREMENTS/SKILL

Must be comfortable in a fast-paced, dynamic environment. Must be able and willing to reprioritize on short notice and work on multiple simultaneous projects. Flexible and able to work with various personalities. Team work skills required. Time management skills required. The ability to meet deadlines in a deadline intensive environment is essential. High level of adaptability and willingness to embrace change in a fast-paced, demanding environment.

LUKE does not discriminate on the basis of race, sex, color, religion, national origin, age, disability or veteran status in provision of services or employment opportunities and benefits. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.

Links:

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