Job Description

Location: Steward Health Care
Posted Date: 8/12/2021

POSITION SUMMARY:

The HIM/CBO team lead will be responsible to maintain DNFB and Unbilled claims for outpatient, day surgery, wound, laboratory, and radiology services. He/she will be responsible to work with the hospital departments to clear edits and reduce denials.

KEY RESPONSIBILITIES:

  • Creates daily assignments for the CBO HIM team in N Thrive
  • Runs HCPCS conflicting Reports for assignments and resolutions
  • Performs clean claim analysis
  • Monitors Xclaim Aging report and keeps current
  • Is a conduit for Coding Manager with the facilities for non-coding related claims which need HIM intervention
  • Creates meaningful education content from clean claim analysis outcomes
  • Maintains schedules and resource availability for the CBO Works with HIM/Centralized Business Office processing Unbilled XClaim edits.
  • Reviews encounters for 72 hour combine for coding/billing compliance
  • Works with the CBO to create edits to ensure prompted payments.
  • Works with CBO to remove edits by payer to improve the clean claim rate.
  • Provides CBO and Hospitals feedback of areas of opportunity if necessary
  • Assists coding manager as needed with coding claim resolutions
  • Communicates and escalates relevant issues to billing as needed
  • Prepares key performance reports for HIM/Coding Leadership
  • Complies with facility policies and regulations.

REQUIRED KNOWLEDGE & SKILLS:

  • Minimum coding certification of CPC, CCS, COC or RHIT
  • Working knowledge of Microsoft PC applications (Outlook, Word, Excel)
  • Ability to foster a cooperative work environment
  • Strong interpersonal/public relations skills and the ability to work effectively with a wide range of customers in a diverse environment
  • Ability to establish priorities effectively
  • Experience with Meditech and XClaim preferred

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

  1. Education: Associates Degree Required, Bachelor’s Degree Preferred
  2. Experience: Prior work experience in outpatient coding edit resolution with knowledge of CCI, OCE, NCCI and LMRP
  3. Certification/Licensure: AHIMA or AAPC coding credential

Application Instructions

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