Responsible for researching medical records for diagnosis, patient history, and procedures for qualifying coverage assigning appropriate ICD-10 codes in collaboration with clinical staff to maximize reimbursement. Assists nurse case manager in placing referrals for nursing services through sub-contracted arrangements when required by third party contract. Enters referral/patient data into infusion software and credentialing new physicians. Maintains current knowledge of home care accreditation standards for billing activities. Maintains a close working relationship with the clinical and patient accounting staff to ensure clear communication and handling of business needs. Reports to Reimbursement and Business Manager.
COMPETENCIES AND SKILLS:
Demonstrated strong mathematical (calculation of percentages, ratios, etc.) and clerical skills, good oral and written communication with ability to communicate effectively, good organizational skills required. Demonstrated ability to maintain current knowledge of insurance coverage, knowledge of ICD-10 codes, and medical terminology. Must have proven experience with word processing software and spreadsheet software.
EDUCATION AND/OR EXPERIENCE:
Minimum of two years’ experience in healthcare related field. High school diploma, associate degree preferred. Maximum of six months to learn all aspects of the job.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment. Requires sitting for long periods of time.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
ABOUT GEISINGER: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.