Children's Healthcare of Atlanta

Medical Billing and Coding

• Provides continuous education and updates to physicians, advanced practice providers, and practice leadership regarding coding and billing practices.
• Provides appropriately messaged individual feedback and facilitates interventions to address educational gaps.
• Develops and implements educational content in compliance with industry standards in collaboration with Leaders, Compliance, Legal and Providers using appropriate adult education principles and strategies.
• Works closely with internal or external vendors/departments to launch materials in live trainings and on a Web-Based platform.
• Collaborates with the Manager of Physician Documentation and Coding Education to develop strategy around design and delivery of all aspects of documentation and coding training.

Behavior Health Educator, Coder

• Provides accurate and timely assignment of appropriate ICD-10 diagnostic and PCS procedural codes on the medical records for the purpose of collecting and indexing quality health information for inpatient hospital encounters.
• Reviews the medical record, identifies the diagnoses and procedures, and assigns ICD-10-CM diagnosis and ICD-10 PCS procedure codes for inpatient accounts.
• Abstracts diagnostic and PCS procedural codes and other pertinent data into the network system as defined in policy and procedures.
• Reviews/monitors assigned work queues and missing documentation encounters as needed, and codes and abstracts any accounts that were missed.
• Provides information on specific problem accounts to the Coding Supervisor.
• Other duties as assigned.

Coder

• Provides accurate and timely assignment of ICD-10 codes
• Reviews medical records and abstracts data

Inpatient Coder

Security Engineer

• Responsible for ensuring the safety and security of patients, visitors, staff, and property
• Conduct regular patrols, monitor surveillance systems, and respond to incidents and emergencies
• Patrol assigned locations on foot or in a vehicle
• Protect evidence or the scene of incidents during accidents, emergencies, or security investigations
• Act as the first responder to incidents such as fire, medical emergencies, security threats, disaster, and other emergencies
• Investigate incidents reported

Security Officer

Insurance

• Authorizes and pre-certifies services by coordinating and performing activities required for verification and authorization of insurance benefits
• Proactively identifies resources available for families if health plan does not include coverage for services
• Coordinates counseling services with Financial Counseling and ensures the standards of Surprise Billing is communicated
• Collaborates with Patient Financial Services (PFS) and Managed Care department regarding denied claims
• May initiate and perform revenue cycle activities required for pre-registration
• Works collaboratively with team members to provide quality service that ensures delivery of safe patient care and services
• Conducts in depth account review including but not limited to, denial management, clinical follow up, and acts as a liaison between clinical stakeholders and payor representation
• Interviews patients and/or family members to secure insurance coverage, eligibility, and qualification for various financial programs
• Coordinates and performs verification of insurance benefits by contacting insurance provider and determining eligibility of coverage
• Confirms referring physician and/or servicing physician has obtained notification/confirmation of prior authorization as needed from insurance company for all scheduled healthcare procedures within assigned department/area
• Contacts referring physicians and or/patients to discuss rescheduling of procedures due to incomplete/partial authorizations
• Acts as liaison between clinical staff, patients, referring physician’s office, and insurance by informing patients and families of any possible changes, updates, responses or follow up
• Monitors patients on schedule, ensuring that eligibility and authorization information has been entered into data entry systems
• Pre-screens doctor’s orders (scripts) received for new patients to ensure completeness/appropriateness of scheduled appointment
• Collaborates with Patient Financial Services (PFS) department to provide all related information regarding denied claims
• Monitors insurance authorization issues to identify trends and participates in process improvement initiatives
• Responds to all inquiries related to authorization/pre-certification issues
• Develops and maintains knowledge in medical terminology, billing and insurance guidelines to ensure compliance with all regulatory expectations

Insurance Verifier

Operations

• Provides oversight and supervision to staff responsible for the daily operations of a practice(s)
• Solves complex practice problems, enhances operations, and identifies opportunities to improve practice
• Proactively supports efforts to ensure delivery of safe, timely and cost-effective patient care and services
• Manages daily operations of practice(s), ensuring staff and processes meet patient, customer, financial, and quality needs
• Manages and leads a team including: interviewing, hiring, training, developing, directing work and processes, managing performance, recognizing, and rewarding employees
• Consistently exhibits appropriate leadership behavior and holds self-accountable to expectations
• Supervises, compiles, analyzes, and manages financial operations of the practice(s)

Practice Operations Supervisor – ENT

Research Analyst

• Provides oversight for all aspects of clinical research occurring within a specified program
• Develops, implements, and supports the research process at an expert level by assisting investigators in study design, completion of the approval process, and management of data
• Provides guidance and assistance in protocol development
• Serves as back-up coordinator to provide ongoing support for all trials in the specified program as needed
• Provides routine auditing/monitoring of ongoing trials for quality assurance purposes