SRCC Billing Coding Specialist

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.   

It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do — in the health of our patients, our loved ones, and our community.

Benefits Eligible

Full-Time Benefit Eligible

Work Shift

Day - 8 Hour or less Shift (United States of America)

Department

7643 SRCC Rad Onc-Visalia

To accurately code and enter all Radiation Oncology services provided by the practice in a timely manner. To comply with all federal and state regulations and Radiation Oncology Certified Coding (ROCC) conventions and the KH corporate compliance programs. Acts as a resource on coding related matters throughout the practice.

License /Certification
Required: Radiation Oncology Certified Coder (ROCC) within 18 months of hire/transfer
Experience
Preferred: Minimum of two years of Radiation Oncology coding and billing experience.
Essential
Performs daily billing/coding of outpatient records by creating a daily report from Soarian Analytics.
Responsible for the audit of all patient accounts, documentation in Cerner and ARIA prior to submission of charges.
Reconciles charges from Cerner Analytics to charges exported out of ARIA daily. Checks for any CCI edits in Craneware and adds any modifiers before exporting charges. Corrects any errors causing charges not to post in Soarian Financials.
Ensures accuracy, completion and timeliness of the billing process on a daily basis.
Posts any charges manually to Soarian for Pyxis medications used for procedures.
Communicates with physicians or physician office staff when documentation is unclear or insufficient to complete the coding/billing process.
Responsible for notifying the Director or Manager of errors and omissions.
Serves as a resource to the billing department for ICD-10 CM and CPT coding questions for the SRCC department and coding SRCC accounts in HIM 3M system.
Participates in quality improvement activities as assigned.
Is an active participant when assigned to attend meetings or is a participant in a team project.
Utilizes computer systems and/or billing reports to review all patient registrations or admissions for demographic information, appropriate financial class, insurance company plans and charges. 100% accuracy of this information is required to ensure proper recording of revenue, necessary authorizations are obtained, payer classification, correct billing of patient accounts and other statistical indicators by use of Cerner/Soarian Financials/ARIA systems. Brings any unresolved issues to the attention of the SRCC Radiation Oncology Manager.
Maintains complete and full knowledge of payer(s) assigned to ensure compliance of specific guidelines and rules, as well as ensuring the Kaweah Health is being reimbursed by the payer accordance with governmental or contract terms. Acts as a resource to the Finance division management regarding the assigned payer.
Acts as liaison/Financial Counselor between patient and SRCC departments obtaining and giving appropriate information to assure payment.
Evaluates the patient’s financial needs, making determinations and referrals to the appropriate agencies for assistance to ensure reimbursement to the hospital.
Makes independent decisions regarding payment arrangements. Refers patient to financial assistance services as needed (i.e., Medical, Tulare County Medical Services, Medicare, Assistance Programs and CCS).
Meets with patient and/or responsible party. Notifies eligibility worker, copies contract and sends to appropriate person. Notifies Patient Accounting of possible debt problems.
Reviews special insurance and program admissions. Obtains all necessary information/authorizations from patient and/or responsible party. Processes paperwork and makes corrections in system as needed.
Documents all information and action taken, maintaining information according to policy.
Addendum (essential for specific dept)
Additional
Seeks constructive feedback from others. Modifies behavior based on feedback. Identifies areas of strength as well as areas where professional development would be beneficial.
Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.
Performs other duties as assigned.

Pay Range

$22.48 -$33.72

If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.