8 Hour Day Shift
Average Hours per Week:
Health Information Management
Via Christi Health's rich history of serving the people of Kansas and the surrounding region dates back more than 100 years to the healing ministries of our founding congregations. Today, Via Christi Health is the largest provider of health care services in Kansas. We serve Kansas and northeast Oklahoma through our doctors, hospitals, senior villages and health services.
This position is responsible for analyzing, reporting and developing recommendations on data related to complex and varied department operational and/or payer metrics.
Key Responsibilities/Essential Functions:
Creates and maintains spread sheets/databases to track coding and/or payer fee trending.
Develops and analyzes operational performance reports (e.g. claims/work files data, provider data, and utilization data) and provides notation of performance deviations, and anomalies.
Manages large quantities of data from various systems and external sources to prepare reports, analysis, graphs, flow charts etc.
Produces ad hoc monthly, quarterly, and semi-annual provider statistical reporting.
Assists with developing claims system edits based on coding denials and payment trends to enhance claims filing efficiencies.
Assists with annual review and updating of diagnosis and procedure coding, encounter forms and templates.
Assists Director of Business Office with projects and special requests.
Performs duties of the Fee/Payer Credentialing Analyst as required.
May perform other duties as assigned or requested
Education and/or Experience
Knowledge of clinical medicine, clinic practice management and health care delivery systems. Knowledge of organizational policies, procedures and systems.
Must have a minimum of 5 years of medical billing or insurance/payer experience; and/or equivalent combination of education and experience.
Ability to assume responsibility and exercise authority over assigned work functions, and to organize and integrate organizational priorities and deadlines.
Ability to prepare and present reports to summarize activities and accomplishments as well as have the ability to communicate with physicians, administration, staff and outside agencies on a professional level.
Requires knowledge of coding compliance guidelines and auditing principles as well as knowledge of physician and facility billing/reimbursement methodologies, claims payment processes and state and federal regulations, including CMS billing guidelines and reimbursement methodologies.
Requires experience with ICD-9-CM, CPT and HCPCS coding. Prefer college level courses in medical terminology, biology, anatomy and physiology, basic pathology. Prefer 3-5 years of coding and medical billing experience in a multi-specialty physician billing environment in addition to knowledge of payer billing guidelines and documentation guidelines.
Thorough knowledge of coding and compliance guidelines as well as previous auditing experience preferred. Experience with CMS insurance program memorandums/transmittals/manuals. Multi-specialty coding experience preferred and thorough understanding of E&M documentation adequacy standards.
Skill in exercising a high degree of initiative, judgment, self-direction and discretion to achieve organizational objectives. Must have excellent communication skills including, interpersonal, written and verbal presentation skills. Must have sound analytical and organizational skills.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals.
A personal presence which is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of Via Christi Health.
Must display good verbal and written communication skills, and be able to professionally receive and follow oral instructions.
Must be able to operate standard office equipment including, computer, fax machine, duplicating machine and telephone.
Certificates, Licenses, Registrations
Requires CPC, RHIT, RHIA or CCS-P certification. Prefer completion of a two to four year program in Health Information Technology or Administration, or Certified Coding Program with a minimum of 5 years of medical billing or insurance/payer experience; and/or equivalent combination of education and experience.
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 accommodationsmay be made to enable individuals with disabilities to perform the essential functions.
Frequently required to carry or lift items weighing up to 10 pounds.
Occasionally required to carry or lift items weighing up to 25 pounds for short distances.
Occasionally required to stand or walk.
Frequently required to sit in a stationary position.
Occasionally performs activities that require stooping, bending and reaching, squatting, balancing, and trunk twisting throughout the day.
Constantly able to communicate verbally and in written form.
Frequently able to detect and discern both loud and soft sounds such as phone calls and customer questions.
Constantly able to use hands and fingers to type, write, and file.
Frequently able to use near vision for viewing computer monitor and written materials.
Occasionally required to detect unusual odors that could indicate environmental issues.
Via Christi Health is an Equal Opportunity Employer.