Lead Patient Billing/Coding Coordinator

at  Nuvance Health

Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care. Non-acute care is offered through various affiliates,

SUMMARY:

Oversees and monitors the billing and coding for the Wound Care and Hyperbaric department. Ensures that all claims are entered accurately, submitted in a timely manner, and compliant with state and federal regulations. As the Lead, will be a resource to the other front office staff and patient billing/coding coordinators in the wound care system. Acts as a subject matter expert in billing/coding for the wound care departments on the west side.

Is a resource to the other front office and patient billing/coding coordinator staff in the wound care system to ensure they understand their role and are able to complete the functions of their positions.
Works with the Regional Business Manager to review issues related to insurance denials/rejections that can be identified and educated to the wound care front office and billing/coordinator staff to mitigate future issues related to the insurance denial/rejection found.
Communicates with and to the clinical manager(s) of the center issues that come up during billing/coding reviews to ensure clinical staff are involved with ensuring proper documentation that leads to proper billing/payments.
Performs all aspects of the assigned wound care facility billing, coding and accounts receivable management, to ensure optimal efficiency and reimbursement, including accurate and timely preparation and submission of claims.
Performs data entry of wound care charges.
Reviews and processes claim edits and rejections prior to submission, to ensure accuracy and optimal reimbursement. Identifies and resolves issues associated with billing, procedures, and system functionality with the clinical manager of the department(s).
Identifies and resolves issues associated with billing, procedures, and system functionality with the clinical manager of the department.
Attends on-going education to maintain current knowledge of registration and billing standards. Adheres to all policies and procedures related to compliance with all federal and state billing and collection regulations and third-party obligations.
Provides feedback to Billing, Coding, A/R, and Managed Care staff regarding changes in procedure, rules, and regulations pertaining to billing, reimbursement, or requirement.
May cover telephones and schedule patient appointments. Assists with insurance verification and/or pre-authorization for treatment/procedures.
Assists with insurance verification and/or pre-authorization for treatment/procedures. Participate in the Cellular Tissue Product procurement process of the center.
Fulfills all compliance responsibilities related to the position.
Maintains and Models Nuvance Health Values.
Demonstrates regular, reliable and predictable attendance.
Performs other duties as required.
Location: Rhinebeck-NDH 6511 Springbrook Avenue
Work Type: Full-Time
Standard Hours: 37.50