Surgery Billing Clerk

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Processes and reviews charging activity in respective hospital assigned areas, and reports system issues and clarification when opportunity for improvements are identified. Provides guidance to supply chain regarding items to be paid and reconciles against clinical documentation.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High School education or equivalent.

EXPERIENCE:

1. Two years previous experience in a health care finance.

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Certified Professional Coder (CPC) Certification or Licensed Practical Nurse (LPN) preferred.

2. Obtain Certified Revenue Cycle Representative (CRCR) certification within 2 years of employment.

EXPERIENCE:

1. Two years previous experience in a health care environment with hospital billing and or charging knowledge.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Maintains an accurate and timely flow of charges incurred by patients in assigned area. 

2. Picks up daily surgery and procedure records for all assigned areas after they have been logged.  Validates usage and processes for payment according to work flow established by materials management.

3. Calculates charges as directed with hospital standard mark-up schedule and other assigned functions in key areas such as OR Room Time & Apply Room Rate based on procedure done.

4. Extracts & Compiles charges for regular, pharmacy, and special items used.

5. Completes daily audit routines including working the OR work queue for financial services to ensure appropriate codes are on claims.

6. Utilizes various EPIC modules daily for review accuracy such as Cupid, OP Time, and various dash boards. 

7. Initiates new procedures or items in Lawson and EPIC with appropriate charge amounts and codes as directed in a timely and accurate fashion.

8. Maintains active dialogue and analyzes volume with other Hospital departments assisting with clarification for charges and adjustments.

9. Demonstrates ability to follow established computer down time procedures.

10. Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth including departmental meetings.

11. Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information.

12. Complies with Notices of Privacy Practices, and the Patient’s Rights and Responsibilities.

13. Demonstrates knowledge of procedure to report and/or document unsafe/hazardous conditions, incidents and defective equipment in compliance with hospital policy.

14. Communicates problems hindering workflow to management in a timely manner.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift.

2. Must be able to sit for extended periods of time.

3. Must have reading and comprehension ability.

4. Visual acuity must be within normal range.

5. Must be able to exert in excess of 50 pounds of force occasionally to move patients or objects.

6. Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Normal Office environment.

2. Patient Care environment.

SKILLS AND ABILITIES:

1. Must possess good communication skills.

2. Ability to work independently.

3. Knowledge of medical terminology.

4. Experience with Windows-based software.

5. Experience with data-entry.

6. Current knowledge of ICD-10 and CPT coding requirements.

7. Demonstrates flexibility to meet the needs of department or hospital in regard to changes in work volume, planned change, scheduling changes and emergency call-backs (i.e. weather or disaster).

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

THOM Thomas Hospitals

Cost Center:

72 THOM Nursing Operating Room

Address:

4605 Maccorkle Ave SW

South Charleston

West Virginia

Equal Opportunity Employer

 

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.