Description
Welcome to Holy Name, a medical center where innovation is not just a goal — it's a commitment. Here, medical excellence thrives, allowing hope to reign supreme and leaving no room for fear. At our hospital, every patient is cared for with undivided attention — because healing every soul is our sole focus.
Holy Name is New Jersey's only independent Catholic health system, comprising a 361-bed acute care hospital, a renowned cancer center, a state-of-the-art fitness center, a residential hospice, a prestigious nursing school, and an extensive physician network. Healing at Holy Name goes beyond medicine and technology – it is infused with faith, conviction, compassion, and a commitment to educating the next generation of healthcare professionals through graduate medical education, a Pharmacy Residency Program, and our Institute for Simulation Learning. Our mission to provide care for the body, mind, and soul spans education, prevention, diagnosis, treatment, rehabilitation, and overall wellness. This is at the core of who we are and what we do, and we've done it this way across generations, every single day, for nearly 100 years. Every innovation, medical breakthrough, and groundbreaking treatment is powered by some of the best minds in medicine, ensuring nothing is left on the table or the road to recovery.
A Brief Overview
Manages all aspects of billing for the physician practice.
What you will do
- Check CPT and Diagnosis codes for appropriate description of services rendered for both hospital and office services.
- Ensure medical necessity is satisfied for billing of CPT/ICD-10 combinations.
- Research insurance eligibility, PCP status, referral required status, global periods, and needed modifiers.
- Research missing information.
- Enter all valid charges while performing reconciliation to appointment schedule and hospital logs.
- Correct rejections from failed validations.
- Take and resolve patient billing calls.
- Review and evaluate denied claims for resubmission.
- Prepare reports by collecting and analyzing information utilizing billing software.
- Ensure the quality of data performed by the billing staff.
- Communicate to physicians and staff common errors and new billing changes.
- Provide coding/compliance education to providers when needed
- Conduct yearly billing and compliance updates for providers
- Assist with various IT initiatives occurring in HPS, including clinical EMR training..
- Complete projects on a timely basis and assimilate directives easily.
- Perform all duties as assigned by Director of Finance, HNPN /Director Medical Records.
- Adhere to all HIPAA standards
Education Qualifications
- Bachelor's Degree BA or BS degree in Accounting, Finance or IT or equivalent work experience in lieu of advanced degree Required
Experience Qualifications
- Solid working knowledge of third party payer’s requirements. Required and
- Managing experience a plus. Preferred and
- Prior experience working with Practice Management and EMR systems Required and
- 4-6 years A minimum of 5 years of billing systems experience preferably in Health Care. Required
Knowledge, Skills, and Abilities
- Strong Excel Skills. Exceptional knowledge of CPT, ICD9, and understanding of ICD10 codes.
- Exceptional phone manner.
- Strong work ethic and a positive, professional attitude.
- Detailed oriented and organized.
- Strong communication skills.
Licenses and Certifications
- CPC Coding Certification a plus Preferred
Holy Name is a mission-driven facility whose quality standards and philosophy are rooted in the principles of its founders, the Sisters of St. Joseph of Peace. Those principles are exercised daily by the Medical Center's dedicated and talented team of physicians, nurses, allied health employees, and a wide variety of non-clinical administrative and operational staff members. Holy Name is an Equal Opportunity Employer.