Claims Edit Specialist-PRN
Jennie Stuart Health
- Hopkinsville, KY
- Permanent
- Full-time
- Provides a positive and professional representation of the organization.
- Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.
- Maintains hospital standards for a clean and quiet patient environment to maintain a positive patient care experience.
- Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of job role or practice.
- Adheres to infection-control policies and protocols, medication administration and storage procedures, and controlled substance regulations.
- Participates in ongoing quality improvement activities.
- Maintains compliance with organization’s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.
- Complies with organizational and regulatory policies for handling confidential patient information.
- Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.
- Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and TJC standards and/or standards from other accrediting bodies.
- As a Studer Partner must have the ability to develop a full understanding of the Studer Group practices and tools and communicate effectively. Must embrace the Studer Philosophy and Principals by conducting him/herself in a professional manner. Will be held accountable to the following Studer Philosophies and Principles:
- Proficiency in applying appropriate charge codes to Emergency Room, Admissions, and Observation accounts, ensuring all charges are captured.
- Effectively communicates with other departments to request information, as well as to review issues, concerns effecting reimbursement.
- Maintains up-to-date knowledge of governmental and managed care policies and procedures. Demonstrates ability to interpret and communicate regulations to ensure compliance.
- Makes recommendations to management, actively participates in continuous quality improvement and enhances reimbursement.
- Understand utilization of modifiers and other coding rules to include: Coding Clinic, AMA, as well as payer specific guidelines.
- Knowledge of medical terminology and consistent application of medical documentation requirements.
- Requires advanced knowledge of ICD-10-CM; ICD-10-PCS; CPT-4; and HCPCS coding systems.
- Experience in assigning Evaluation and Management, injection and infusion administration codes.
- Ability to prioritize workload to meet established timelines
- Attention to detail in entering data accurately
- Experience in 3M Coding/Reimbursement System
- Proficiency in following established coding policies and procedures
- Excellent organizational skills
- Ability to effectively collaborate remotely with management, HIM staff, medical staff, Business Office.
- Proficient in Microsoft Excel and Word.
- Assist with charge entry in all areas as needed.
- Requires advanced knowledge of charge functions, ICD-10-CM, CPT-4, and HCPCS coding systems. Required Licenses: CCS, CCS-P or CPC. RHIT preferred.
- Associate or Bachelor’s Degree in health care or business equivalent is preferred.
- Requires advanced knowledge of charge functions, ICD-10-CM, CPT-4, and HCPCS coding systems. Required Licenses: CCS, CCS-P or CPC. RHIT preferred.
- Associate or Bachelor’s Degree in health care or business equivalent is preferred.