Coder/Charge Entry Specialist

Supervisory Responsibilities: None

Objective: The Coder/Charge Entry Specialist determines appropriate payer, charges, diagnosis and other information necessary to accurately bill for services.

Essential Duties:

• Know and support the Mission Statement, Policy/Procedures and standards of MMR.
• Review dispatch information and patient care reports along with other documents to accurately determine service type, level, diagnosis, medical necessity, charges and payer, for assigned days (even/odd).
• Code the patient diagnosis code utilizing the ICD10 coding system.
• Select the correct HPPCS code.
• Understand proficiently Tier 1/Tier 2, ALS 1 with and w/o ProQA/EMD) ALS 2, SCT/Neonate/Emergency and non-emergency transports and how these assist in determining the charges.
• Understand proficiently EMT-Basic, EMT-Paramedic, Specialty Care Transport (SCT) trained staff.
• Complete narrative and ambulance certification areas.
• Places claim in appropriate schedule i.e., Auto 1/Neonate 1/Care/Caid, etc.
• Verify the claim.
• Maintains HIPAA compliance.
• Perform and assist with other duties as assigned.

Knowledge, Skill and Competency Requirements:

• Two or more years of medical billing experience including appeals resolution
• Must be well versed in daily operations as it pertains to the ambulance industry and operations
• Must proficiently use insurance websites i.e., C-Snap, Champs, Web Denis, etc., 2 months after date of hire
• Reading skills to comprehend correspondence and materials specific to the healthcare industry
• Writing skills to compose complex correspondence or reports with minimal direction provided
• Must demonstrate ability to maintain security and confidentiality with utmost discretion
• Ability to communicate effectively both verbally and in writing, in the English language
• Ability to organize tasks and insure timely completion of all projects
• Advanced computer skills including the ability to utilize a computer PC with Windows operating system
• Ability to operate office equipment, including but not limited to, copier, fax machine, scanner, monitor, multi-line telephone, printer, typewriter and calculator
• Proficiency with Microsoft Word and Excel
• Regular attendance and timeliness
• Skilled in typing, data entry, scanning, electronic filing and document retrieval
• High School Diploma
• Must be at least 18 years old

Physical Factors: Suitable dexterity to operate standard office equipment. Capability to stand or sit for extended periods of time.

Working Conditions/Environment: Most work is done in a typical office setting with daily exposure in all other department areas. Regular, in-person attendance is an essential function of the job. Materials and equipment used include desktop computer, telephone, fax, copier, printer and other standard office equipment. Hours must be flexible to meet the demands of the office.