Research Billing Coder

Jefferson Health Plans; Philadelphia (Philadelphia County); On-site; USD 55,000 - 75,000; Full time

Job summary

Thomas Jefferson University is seeking a Billing Compliance Specialist to review technical and professional charges related to clinical research. Under supervision, you will ensure billing and coding comply with federal regulations and enterprise policies for clinical research.

Responsibilities include accurate research billing review, coordinating with clinical research staff, and communicating issues to stakeholders.

Qualifications

• 2 years or more of experience in billing and/or coding operations in Healthcare.
• Experience using Microsoft Word and Excel.
• Knowledge of CPT coding, third-party rules and medical terminology.
• Experience working in electronic medical record systems.
• CPC certification or CCS certification held.

Responsibilities

• Ensures accurate and timely research billing review of hospital and professional charges.
• Consults with clinical research personnel for clarification of clinical data.
• Communicates daily about issues or concerns regarding clinical research billing.
• Works with hospital and physician services to perform billing corrections.
• Serves as initial point of contact for clinical research billing inquiries.
• Interacts with staff and departments in line with Jefferson values.

Skills

Billing & Coding Operations

EMR systems experience

Microsoft Word

Microsoft Excel

Education

High School Diploma/GED

CPC - Certified Professional Coder

CCS - Certified Coding Specialist

Tools

Microsoft Word

Microsoft Excel

Job description

Number of Positions In Requisition

3

Job Details

Under general supervision and according to established procedures, this position will be responsible for reviewing technical and professional charges related to clinical research.
This position will ensure all federal regulations and enterprise policies and procedures are adhered to with respect to billing and coding for clinical research.

Job Description

Summary

Under general supervision and according to established procedures, this position will be responsible for reviewing technical and professional charges related to clinical research. This position will ensure all federal regulations and enterprise policies and procedures are adhered to with respect to billing and coding for clinical research.

Job Duties

• Ensures accurate and timely research billing review of all hospital and professional charges in accordance with the final coverage analysis
• Consults with clinical research personnel for clarification of clinical data when encountering conflicting or ambiguous information and/or missing documentation
• Communicates daily to appropriate parties regarding any issues or concerns pertaining to clinical research billing
• Works with hospital and physician services to perform research billing corrections, as appropriate
• Serves as initial point of contact regarding clinical research billing inquiries from internal business partners and escalates to supervisor, as appropriate
• Works with clinical research administrators to process interdepartmental transfers for sponsor-paid, study-related hospital and professional charges
• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson

Minimum Qualifications

• High School Diploma/GED
• 2 years or more of experience in the area of billing and/or coding operations in Healthcare.
• Experience using Microsoft programs, including Word and Excel.
• Knowledge of CPT coding, third-party rules and regulations, and medical terminology.
• Experience working in electronic medical record systems required.
• CPC - Certified Professional Coder - American Academy of Professional Coders or
• CCS - Certified Coding Specialist - American Health Information Management Association

Preferred Qualifications

• Associate’s Degree
• Use of Epic preferred.

Physical Demands

Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University

Primary Location Address

833 Chestnut Street, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow’s professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time(including per diemcolleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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