Job Information
Guthrie Reimbursement Coordinator-Corporate Reimbursement/ Coding- Full Time in Sayre, Pennsylvania
Position Summary:
Responsible for reviewing clinical documentation to accurate assign CPT, ICD‐10, and modifiers. Responsible for coding multispecialty services including procedures, evaluation and management, ancillary procedures and works variance coding workqueues. Provide a high level of technical competency and serves as a subject matter expert regarding documentation guidelines, coding, and reimbursement. Works in collaboration with providers, operational managers, and CBO. Will coordinate, implement and support billing and coding processes.
Education, License & Cert:
High School Diploma or equivalency required
Degree in Health Information Technology or possession of RHIA, RHIT, CCS or CPC certification desirable. Recommend CPC Certification be obtained within 18 months of date of hire.
Experience:
Must have a proficient knowledge of Medicare, Medicaid, and other third party payer coding and billing regulations. Must be able to demonstrate a strong knowledge of CPT, ICD‐10‐CM and HCPCS coding systems and guidelines, medical terminology, anatomy, and physiology.
Essential Functions:
Manually code provider services by reviewing clinical documentation to assign the appropriate CPT, ICD‐10, and modifiers.
Responsible for working coding edits to assign appropriate codes within coding edits daily to ensure appropriate and timely capture of revenue.
Perform clinical and coding reimbursement assessments to ensure revenue capture. Make recommendations to appropriate providers, staff, and leadership partners.
Communicate with all parties involved the results of quality coding/documentation reviews.
Maintains working knowledge of payor regulations and third‐party guidelines.
Perform special audits upon request to analyze billing activity.
Ensure all regulations are met and claims subsequently submitted to payers accurately.
Other Duties:
Contribute to maintain a team environment. Must work in a way that demonstrates and promotes teamwork.
Maintains confidentiality regarding patient accounting.
It is understood that this description is not intended to be all‐inclusive and that other duties may be assigned as necessary in the performance of this position.
Rev: 1-15-2024
Joining the Guthrie team allows you to become a part of a tradition of excellence in health care. In all areas and at all levels of Guthrie, you’ll find staff members who have committed themselves to serving the community.
The Guthrie Clinic is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace.
The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania. Our multi-specialty group practice of more than 500 physicians and 302 advanced practice providers offers 47 specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.