Ochsner Health

Compensation

Full Description

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today! This job researches, analyzes and resolves pre-bill errors/edits related to provider based billing and outpatient diagnostic testing. Works closely with the Business Office in researching post billing denials, patient inquiries, identifies and documents, and recommends solutions to the root cause of the problems to improve the overall internal and operational system efficiencies and optimizes revenues. Advises department leadership on HIM and billing issues including soft coding processes to ensure all charges and medical documentations are appropriate and complete. Education Required - High School diploma or equivalent Work Experience Required - Analytical, interpretive, communication, decision-making, judgment and technical writing skills Preferred - Coding review experience in ICD-9-CM / ICD-10-CM Certifications Required - Certification from an accredited Billing and Coding trade school OR successful completion of the company's coding intern program Certified Professional Coding certification required within 6 months of employment (CPC, CPC-H, CIC, CPC-P, CANPC, CCC, CEDC, CEMC, CGIC, CGSC, CIRCC or COSC) Knowledge Skills and Abilities (KSAs) Must have computer skills and dexterity required for data entry and retrieval of required job information. Must be proficient with Windows-style applications and keyboard. Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout required job processes. Analytical, interpretive, communication, decision-making, judgment and technical writing skills. Leadership, interpersonal and time management skills including the ability to prioritize, organize and coordinate multiple areas and assignments under fast-paced, changing conditions and constant interruptions to meet deadlines. Self-directed including the ability to work with minimal or no supervision and maintain confidentiality. Deductive reasoning skills to anticipate issues that adversely impact the function of the department and to solve problems. Detail oriented with the ability to develop and facilitate presentations, seminars, and workshops. Ability to work evenings, weekends, holidays, and extended shifts as needed. Ability to travel throughout and between facilities as needed. Job Duties Resolves or coordinates the resolution of pre-bill edits, post-bill denials and patient inquiries on a timely basis related to limited outpatient accounts such as provider-based billing and outpatient diagnostic testing in Epic and X-claim. Resolves and provides education and feedback to Billing and Follow-up team to continuously reduce the number of edits. Plans, organizes, and prioritizes work, maintains department QA and productivity standard, and exhibits continuous improvement of knowledge related to coding edits. Reviews policies, procedures, and practices for compliance with established legal standards and state guidelines and ensures that all work complies with standard departmental procedures and guidelines. Assumes responsibility for professional development and completes special projects as assigned. Other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time. Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Physical and Environmental Demands The physical essential functions of this job include (but are not limited to) the following: Frequently exerting 10 to 20 pounds of force to move objects; occasionally exerting up to 100 pounds of force. Physical demand requirements are in excess of those for sedentary work. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role. Are you ready to make a difference? Apply Today! Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website. Please refer to the job description to determine whether the position you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New York, Vermont, Washington, and Washington D.C. Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or careers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities. Ochsner Health is the leading not-for-profit healthcare provider in the Gulf South, delivering expert care at its 46 hospitals and more than 370 health and urgent care centers. For 12 consecutive years, U.S. News & World Report has recognized Ochsner as the No. 1 hospital in Louisiana. Additionally, Ochsner Children’s has been recognized as the No. 1 hospital for kids in Louisiana for three consecutive years. Ochsner inspires healthier lives and stronger communities through a combination of standard-setting expertise, quality and connection not found anywhere else in the region. In 2023, Ochsner Health cared for more than 1.5 million people from every state in the nation and 65 countries. Ochsner’s workforce includes more than 38,000 dedicated team members and over 4,700 employed and affiliated physicians. To learn more about how Ochsner empowers people to get well and stay well, visit https://www.ochsner.org/. Ochsner Health is proud to be an Employer of Choice. Ranked one of Newsweek's list of America's Greatest Workplaces for Diversity of 2024 Becker's Healthcare listed Ochsner Health as 150 Top Places to Work in Healthcare Awarded Culture Awards for Purpose and Values and Healthcare Industry by Top Workplace Ranked as a 2023 Top Workplace in the USA! The Top Workplaces USA award is based entirely on feedback from an employee engagement survey completed by the employees of participating workplaces. Awarded Top Work Places 2023 for six consecutive years by The Times-Picayune Earned 2022-2023 Great Place to Work Certification™ Ochsner Health named to Newsweek's America's Greatest Workplaces for Parents and Families 2023 Opportunities listed here represent open positions at Ochsner Health and Ochsner Health managed entities.