Northeast Georgia Health System

Medical Billing and Coding

• Receive hands-on training and feedback on assigning codes to patient accounts
• Gain experience to become an independent medical coder
• Reviews work queue assignments and prioritizes by date, charges and payors
• Assigns and sequences diagnosis and procedure codes using appropriate classification systems
• Follows coding guidelines and billing requirements to ensure compliance
• Verify charge entries are accurate based on the documentation provided
• Identify and escalate any obstacles to fulfilling job responsibilities

HIM Coder

• Code the most complex inpatient and/or outpatient service types and resolve any associated edits
• Respond to coding related questions from other departments
• Review and respond to denials
• Represent coding in meetings as needed
• Review work queue assignments and prioritize work to meet revenue cycle goals
• Assign and sequence diagnosis and procedure codes using appropriate classification systems
• Initiate physician query in compliance with Company policy when appropriate

HIM Facility Outpatient Coder III

• This is an Advanced Level III position in which the employee has demonstrated an advanced knowledge of ICD-10 CM-PCS and CPT coding guidelines and is fully competent to independently code the most complex inpatient and or outpatient service types and resolve any associated edits.
• Responsible for responding to coding related questions from other departments and for assisting in reviewing and responding to denials.
• May be called upon to represent coding in meetings.
• Reviews work queue assignments and prioritizes work by date, charges and payors to meet revenue cycle goals.
• Assigns and sequences diagnosis and procedure codes using appropriate classification systems and official coding guidelines to insure that DRG (Diagnosis-related group) or APC (Ambulatory Payment Classification) assignment is correct.
• Codes inpatient (IP), same day surgery (SDC), observation (OBS), emergency department (ED), recurring (RCR), and clinical (CLI) records, including the assignment of ICD-10-CM, Procedure Categories, modifiers (when applicable) and HCPCS/CPT codes across multiple facilities and possible E/M levels.
• Reviews documentation and possibly charges to correctly assign outpatient procedure codes (ED Only).
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current.
• Initiates physician query in compliance with Company policy when appropriate.
• Reassign accounts with missing or incomplete documentation/charges to appropriate work queues.
• Correctly abstracts discharge disposition, performing physician, and procedure dates.
• Corrects discharge disposition based on payer requirements.
• In- depth knowledge of coding and charging requirements necessary to resolve billing edits at time of coding.
• Works with revenue cycle to resolve issues related to billing.
• Ability to audit coding quality and provide feedback on an as needed basis.
• As a remote employee must be able to organize work to ensure goals are met.
• Identifies and escalates any obstacles to fulfilling job responsibilities.
• Must maintain coding certification, continue to work towards knowledge base growth by cross-training to learn other patient types and attend in-service training as required.
• Attends and actively participates in huddles/meetings/committees as required and appropriate.

HIM Inpatient Coder III

Business Analyst

• Assess customer analytic needs and provide guidance on best action
• Generate real-time or near real-time application reports using Reporting Workbench
• Develop custom metrics and SQL reports
• Collaborate with operational team members and leadership for analysis
• Develop and implement training and documentation solutions for self-service analytics tools

Senior Reporting Business Analyst, Epic EHR

Payroll

• Analyze and manage payroll and financial management systems to ensure accurate payroll and 1099 processing and tax compliance
• Maintain payroll integrity and resolve tax discrepancies
• Support audits and reporting requirements and identify process improvements
• Lead payroll tax operations and prepare, file, and monitor payroll tax returns
• Serve as liaison with tax authorities and maintain strong relationships
• Support audits by compiling documentation and implementing action plans
• Monitor legislative and regulatory changes affecting payroll taxation
• Train and mentor payroll staff on tax compliance
• Partner with teams to enhance reporting capabilities and improve accuracy

Payroll Tax Analyst

• Review, resubmit, and follow up on complex insurance claims.
• Perform detailed account research and update account information accurately.
• Resolve denials and ensure adherence to payer contract requirements.
• Maintain work queues and ensure timely resolution of accounts.
• Provide support to teammates and cross-train in additional revenue cycle functions.
• Demonstrate strong documentation, analytics, professionalism, and customer service.

Bilingual Revenue Cycle Specialist II – Medical Billing, Collections

Therapist

• Administers and coordinates treatment for respiratory problems
• Provides effective direct care as part of an interdisciplinary team
• Communicates updates to team members
• Responds to emergency and critical situations
• Assesses patients and determines treatment
• Attends tier 1 huddles and staff meetings
• Participates in unit practice council
• Documents treatments and medications in EMR

Respiratory Therapist, RRT – NICU – PRN

Call Center Representative

• Assists in monitoring call volumes to ensure achievement of service standards
• Responsible for specialty accounts to include: high balance accounts, payroll deduction and long-term payment plan processing, deceased and estate accounts, bad address/held statement review, bankruptcy processing, and client (non-patient) billing and collections
• Provides staff with support, answering questions and ensuring the team consistently provides accurate information and exceptional customer service
• Responds as needed to escalated calls and serves as department liaison for systemwide Patient Complaint Management System
• Assists with monitoring the team’s customer service skills, working with the Patient Contact Center leadership in identifying areas that require further development/training
• Collect, analyze and summarize data and track trends from various performance and audit reports
• Ensure that customers' questions and problems are resolved properly and quickly
• Review and resolve complaints logged on SPRC complaint tool received by PCC staff and referred to PCC using NGHS complaint tool
• Review specialty accounts for resolution and trending

Patient Contact Center Lead

Medical writer

• Responsible for improving the overall quality and completeness of clinical documentation
• Facilitates modifications to clinical documentation through interaction with physicians and staff to ensure appropriate reimbursement
• Ensures accuracy and completeness of clinical information for measuring and reporting outcomes
• Educates team members on coding and documentation requirements
• Conducts ongoing follow-up reviews and interacts with healthcare providers to improve documentation

Registered Nurse – Clinical Documentation Specialist, CDIP, CCDS

• Handling outbound and inbound patient phone calls related to patient collection activities
• Providing efficient and professional customer service
• Researching and documenting all performed work
• Referring patient accounts to bad debt agencies appropriately
• Managing high-volume inbound and outbound calls related to patient collections
• Delivering professional, courteous, and efficient customer service
• Researching account details and accurately documenting all interactions
• Ensuring appropriate referral of accounts to bad debt agencies when necessary

Revenue Cycle Specialist I – Patient Contact Center, Collections / Billing

Manager

• Supervise operational, Human Resource, administrative, and business functions.
• Oversee patient reception, appointments, and scheduling.
• Provide customer service and manage patient complaints.
• Assist providers in managing schedules and credentialing.
• Supervise practice staff and provide employee evaluations.

Practice Manager III – Pediatrics

• Supervise operational, Human Resource, administrative, and business functions in large scale practices
• Provide administrative and clerical support to encourage a patient-centric care environment
• Address significant customer concerns both verbally and in writing
• Ensure compliance with specified regulatory requirements using established policies and procedures

Data Analyst

• Monitor data metrics and prepare dashboards for relevant quality metrics
• Monitor compliance with Quality metrics as assigned by leadership
• Support Quality Committee and Clinical Councils related to quality metrics
• Obtain data from existing/future organizational information systems to support/enhance clinical and business decisions
• Work with Neurosciences depts and leadership on quality process improvement projects as requested by leadership
• Assures the production of clear and concise appropriate quality dashboards
• Ensures appropriate data is represented and entered on respective quality dashboards
• Develops structured process for specific requests, information or studies
• Responsible for providing quality data to support the Neuroscience Service Line certification programs
• Uses existing reporting dashboards for analysis
• Creates new dashboards or reports as needed to achieve quality metrics for process improvement projects
• Facilitates collaboration for process improvement
• Provides support to Neurosciences services staff as required for service line quality functions
• Supports staff and encourages in them a sense of ownership of their work process
• Maintains system confidentiality with all PHI and registry data
• Assigns weekly cases to the Neuroscience abstractors and ensures completion
• Monitors data submission to registries to ensure accuracy

Registered Nurse RN, Data Analyst – Neuroscience, Part Time, Days

• Handle high volumes of inbound and outbound patient billing calls
• Address inquiries and complaints related to professional and facility services
• Explain insurance responsibilities and communicate denial reasons
• Help patients understand the medical billing process for services rendered
• Resolve billing inquiries and complaints, ensuring accurate documentation of all interactions
• Perform required actions to correct balances found to be in error
• Analyze all details of accounts for accuracy and resolve insurance questions
• Research all patient complaints and inquiries in a timely manner

HIM Coder

HIM Facility Outpatient Coder III

HIM Inpatient Coder III

Senior Reporting Business Analyst, Epic EHR

Payroll Tax Analyst

Bilingual Revenue Cycle Specialist II – Medical Billing, Collections

Respiratory Therapist, RRT – NICU – PRN

Patient Contact Center Lead

Registered Nurse – Clinical Documentation Specialist, CDIP, CCDS

Revenue Cycle Specialist I – Patient Contact Center, Collections / Billing

Practice Manager III – Pediatrics

Practice Manager III – Pediatrics

Registered Nurse RN, Data Analyst – Neuroscience, Part Time, Days

Patient Contact Center Representative II