Job Summary

　　Knowledge of CPT, HCPCS, CMS claim formats (1450 and HCFA 1500) Understanding of general billing and reimbursement guidelines or healthcare background

　　Effectively manages time and resources.

　　Processing pended claims and provider appeals, which consists of reviewing medical records and using various coding resources to confirm correct coding.

　　Beginning with Microsoft (Word, Excel, Visio, OneNote, etc.)

　　Essential Functions

　　Meets with providers and coding employees regularly on billing, coding and reimbursement issues applicable to their specialty.

　　Reviews monthly reporting from billing system with a focus on revenue cycle metrics, unbilled accounts, and adequate documentation.

　　Acts as a liaison between the Coding department and Spectrum Health to enhance educational awareness of coding and documentation. Participates and initiates process and quality improvement activities.

　　Reviews coding patterns/trends and provides ongoing consultation to providers regarding coding and documentation issues.

　　Proactively identifies and communicates problems and opportunities; actively recommends and implements solutions or process improvements.

　　Presents information to physicians, administrators and other institutional leadership.

　　Acts as an expert resource for administrators and physicians in regulatory, coding, billing compliance and financial functions.

　　Qualifications

　　Required Bachelor's Degree accounting, finance, health care administration, or related field or equivalent combination of education and experience

　　2 years of relevant experience progressive experience in various hospital functions (e.g., professional/facility coding, reimbursement, billing, and/or chargemaster maintenance) Required

　　CRT-Registered Health Information Administrator (RHIA) - AHIMA American Health Information Management Association Upon Hire required Or

　　CRT-Registered Health Information Technician (RHIT) - AAPC American Academy of Professional Coders Upon Hire required Or

　　CRT-Coding Specialist (CCS) - AHIMA American Health Information Management Association Upon Hire required Or

　　CRT-Professional Coder - AAPC American Academy of Professional Coders Upon Hire required

　　Physical Demands

　　Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs

　　Waist to Waist > 5 lbs: Seldom up to 10 lbs

　　Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs

　　Waist to Overhead > 5 lbs: Seldom up to 10 lbs

　　Bilateral Carry > 5 lbs: Seldom up to 10 lbs

　　Unilateral Carry > 5 lbs: Seldom up to 10 lbs

　　Pushing Force > 5 lbs: Seldom up to 10 lbs

　　Pulling Force > 5 lbs: Seldom up to 10 lbs

　　Sitting: Frequently

　　Standing: Occasionally

　　Walking: Occasionally

　　Forward Bend - Standing: Seldom

　　Forward Bend - Sitting: Occasionally

　　Trunk Rotation - Standing: Seldom

　　Trunk Rotation - Sitting: Occasionally

　　Reach - Above Shoulder: Seldom

　　Reach - at Shoulder or Below: Seldom

　　Handling: Occasionally

　　Forceful Grip > 5 lbs: Seldom

　　Forceful Pinch > 2 lbs: Seldom

　　Finger/Hand Dexterity: Frequently

　　Primary Location

　　SITE - Priority Health - 1239 E Beltline - Grand Rapids

　　Department Name

　　PH - Medical Code Review

　　Employment Type

　　Full time

　　Shift

　　Day (United States of America)

　　Weekly Scheduled Hours

　　40

　　Hours of Work

　　8 a.m. to 5 p.m.

　　Days Worked

　　Monday to Friday

　　Weekend Frequency

　　N/A

　　CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

　　Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

　　Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

　　An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

　　You may request assistance in completing the application process by calling 616.486.7447.

　　People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.