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Under general supervision, coordinates billing activities; ensures maximum reimbursements and compliance with departmental, University, University Medical Group, IDX billing system, and healthcare governing agency policies and procedures; supervises staff; provides data and prepares reports.
Knowledge of billing, reimbursement, and third-party regulations
Knowledge of University and healthcare governing agency policies and procedures
Knowledge of medical terminology
Interpersonal/human relations skills
Verbal and written communication skills
Planning and organizational skills
Ability to code procedures and diagnoses using CPT and ICD-9 coding
Ability to interpret accounts and records, and develop spreadsheets and reports
Ability to perform basic bookkeeping and compile statistics
Ability to type, and operate personal computer and various office equipment
Ability to prepare reports, and maintain records and files
Ability to extract data from conversations and documents
Ability to maintain confidentiality
Associate’s degree in related coursework; supplemented with three to five (3-5) years related experience. Certified Professional Coder (CPC) through American Academy of Professional Coders, or Certified Coding Specialist (CCS) is required.
Monitors billing procedures and documentation, and provides updates regarding reimbursement and regulatory compliance; conducts periodic audits; maintains files; maintains resource library related to department coding and billing regulations and compliance
Supervises, hires and orients billing staff; assigns work, develops work schedules, and instructs in proper billing procedures; assists with development and revision of departmental billing processes/procedures; monitors staff performance and provides feedback; ensures staff is obtaining adequate billing information; provides opportunity for associated billing training for staff
Assigns accurate billing codes; selects appropriate account for charge entry; posts charges; verifies billing from reports and other source documents; ensures reconciliation of revenues and charges; maintains statistics; prepares charge and billing reports.
Reviews and follows-up on denials and reimbursement relative to coding and charge entry processes to maximize cash flow, reimbursement, and to assure regulatory compliance; provides assistance with revenue projections.
May coordinate UMG faculty credentialing and hospital privileges; performs other duties as assigned
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