Billing Specialist

SUMMARY Under the general supervision of the Administrative Coordinator and Practice Manager, and according to established guidelines, ensures accurate assignment of diagnostic, service, and procedures coding of dental patient encounters. These duties include qualitatively analyzing dental patients' dental record to assign CDT codes within the parameters of Brown University Health's standards. Functions as a coding/billing resource to department staff. Researches and reconciles coding errors or omissions. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. Brown University Health employees are also expected to demonstrate the core Success Factors that tell how we work together and how we get things done: Instill Trust and Value Differences; Patient and Community Focus and Collaborate. RESPONSIBILITIES Reviews dental record documents and patient encounter forms for dental patients to identify and assign appropriate diagnosis and procedure codes. References appropriate coding manuals to ensure accurate assignment of billing codes. Applies sequencing guidelines to coded data according to established coding protocols and in compliance with AHIMA’s Code of Ethics and directives from CMS and ADA. Contacts dentists and other health care professionals to obtain or clarify missing or ambiguous information contained within the record. Enters coding/billing information into the Dentrix computerized billing system. Creates paper invoices as necessary. Reviews related revenue reports regularly to reconcile charges on patient ledgers against the reported data. Researches and reconciles missing charges and/or corrections into the billing system. Interacts with patients and Patient Financial Services to resolve billing issues, including denials. Performs regular audits to identify completeness and accuracy of documentation and to promote and maintain compliance with payor reimbursement policies and governmental regulations (including Medicare/CMS Guidelines). May review electronic dental records to assess adequacy of documentation to ensure appropriate support for the principal diagnoses, principal procedure, complications, co-morbid conditions, secondary diagnoses and procedures to facilitate accuracy and completeness of coding activities. Reports inconsistencies in documentation to the Administrative Coordinator. Functions as a resource to others within the department, including coding and professional staff for questions related to coding and billing activities. Maintains knowledge of outpatient compliance and reimbursement policies and practices, including medical necessity and coding issues. Refers more complex questions or issues to the Administrative Coordinator. MINIMUM QUALIFICATIONS High School Diploma or equivalent. Training in CDT coding, anatomy, physiology, and dental terminology. Experience with dental software, preferably Dentrix. Demonstrated knowledge of PC skills using the Windows operating system environment and accompanying software packages. Knowledge of medical/dental billing routines for physician office practice. Proficiency in courteous telephone technique and good customer service skills. Interpersonal skills to exchange factual information with patients and outside agencies with cultural sensitivity and professionalism. Two years’ related experience coding and billing using dental billing software and demonstrated expertise and accuracy of code assignment. None for supervisory responsibility. PAY RANGE $22.04-$36.37 EEO STATEMENT Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. LOCATION Rhode Island Hospital – 593 Eddy Street, Providence, Rhode Island 02903 WORK TYPE M-F 8:00 am–4:30 pm WORK SHIFT Day DAILY HOURS 8 hours DRIVING REQUIRED No #J-18808-Ljbffr