Billing and Coding Specialist II

At WHA, we're a team, passionate about humanizing healthcare. We're inspired by the diverse stories, strength and resilience of our patients and the unique choices they make in pursuing health for themselves and their families. We envision a world where every person has the opportunity to achieve their optimal health and we're here to support that journey with personalized, culturally competent care and knowledge.

The Billing and Coding Specialist II will review claims data to ensure the assigned procedural and diagnosis codes meet required legal and insurance rules.

*Remote work option open only to Oregon and SW Washington residents, after completion of on-site training.

New employees hiring externally into this position will be eligible for a $5000 hiring bonus!

DUTIES

• Validates charges and documentation to ensure billing codes are accurate prior to claims submission. Seeks clarification from provider and/or clinical staff as needed.
• Applies coding (CPT, HCPCS, and ICD-10) and modifiers accurately and appropriately.
• Applies payer specific coding requirements as appropriate.
• Codes for all services performed at WHA. Services may include office visits, wellness exams, in office surgeries & procedures, injections, supplies, lab, ultrasound, screening mammography, behavioral health, maternal fetal medicine, inpatient and outpatient hospital services, birth center, and ambulatory surgical center.
• Assists with prior authorization coding and accounts receivable coding denial reviews.
• Adds account notes when a claim has been changed or reviewed.
• Provides feedback to coding or auditing supervisor if there are trends in coding errors.
• Attends job related in-service education programs.
• Participates in continuing education programs to increase coding knowledge.
• Mentors and trains other coders within the department as needed.
• Maintains accuracy and productivity in accordance with WHA's Coding Standards.
• Understands the EPIC Cadence platform and Epic Resolute module, including patient registration and guarantor snapshot.

QUALIFICATIONS

• High school diploma or GED required.
• Coding certification through AAPC or AHIMA required. CPC preferred.
• At least three years of experience in medical coding required and two years of experience with OBGYN/MFM coding preferred.
• Knowledge of medical terminology and coding, including, ICD-10, CPT and HCPCS required. OB/GYN specific knowledge preferred.
• Experience in Epic is preferred.
• Demonstrated ability to be detail oriented with strong aptitude for accuracy required.
• Demonstrated ability to effectively work with others required.
• Knowledge of local and major national medical insurance practices preferred.
• Knowledge of proper business writing standards for letters and memos including the ability to write correspondence with proper punctuation, grammar, spelling, etc.
• Proven effective verbal, listening and written communications skills.

Salary Range/Equity Pay Analysis: Please note per the Oregon State Pay Equity Law your salary is determined based on the experience and education listed in your resume/application. It is strongly encouraged to include any transferable experience to ensure your offer is reflective of all directly related and equivalent experience. Please be specific with dates of positions, skills, and educational experiences related to the job you are applying for within your application materials.

WHA is 2023's #1 Largest Women-Owned Business in Oregon and Clark and Skamania Counties from the Washington-Portland Business Journal.

Women's Healthcare Associates, LLC is an equal opportunity employer.

Oregon employers are required by a number of state and federal agencies to display a variety of workplace notices and posters, including:
Federal Family and Medical Leave Act
https://www.dol.gov/whd/regs/compliance/posters/fmlaen.pdf
Oregon Family Leave Act
www.oregon.gov/boli/TA/docs/oflaposter2016englishlarge.pdf