Billing Abstractionist - Division of Ophthalmology

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About the Job
This role is responsible for preparing and entering surgical and in-patient billing for the Division, ensuring the accuracy of outpatient billing and assisting with account reviews/account receivable / appeals follow up.

This role will be responsible for reviewing medical record documentation and timely charge submissions and or data entry of the coded billing services.

What you will do

• Ensures timely and accurate release of all outpatient charges.
• Reviews the patient's EMR including visit notes, Op Notes, inpatient consult notes, etc. and abstracts/confirms CPT Procedure codes and ICD-10 codes for all surgeries and inpatient encounters and enters into billing system.
• Ensures pre-certifications/authorizations are valid for the procedure performed.
• Performs daily maintenance on divisional billing work-queues.
• Assists in finding resolutions to billing issues : rejections, non-paid accounts, etc.
• Communicates with families, assisting with billing/insurance questions and collecting surgical prepayments.
• Maintaining thorough knowledge of coding and documentation requirements outlined by CPT, ICD-10 CMS and CHOP Compliance for all physician services performed.
• Supports special projects assigned by Manager.

Education

• High School Diploma / GED Required

Experience

• At least three (3) years experience in health insurance billing or reimbursement. Required
• At least one (1) year coding experience Required

Knowledge, Skills and Abilities

• Advanced knowledge of specialty coding.
• Advanced knowledge of ICD10, third party procedures, and requirements regarding benefit structures, insurance verification, referrals and authorizations.
• Advanced knowledge of general financial counseling and the revenue cycle.
• Familiarity with electronic health records (EHR).
• Intermediate proficiency with office software (Microsoft Office) including word processing and spreadsheet software (Word, Excel)
• Excellent verbal and written communications skills
• Excellent interpersonal skills
• Strong critical thinking / problem-solving skills
• Strong analytical skills
• Ability to maintain confidentiality and professionalism
• Ability to work independently with minimal supervision
• Ability to gather, analyze and make recommendations/decisions based on data
• Ability to convey complex or technical information in an easy to understand manner

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, professionals working onsite-at any CHOP location, for any portion of time-must be vaccinated for COVID-19. Learn more.

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SALARY RANGE:

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

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At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.