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Cherokee Indian Hospital Authority is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).  To read more about this, view the EEO is the Law poster and this EEO is the Law Poster Supplement

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Billing Technician II
Job Code:2021-02-001
Department:Business Office
FT/PT Status:Regular Full Time
Salary Minimum14.79
Salary Midpoint17.37
  
Position Closes:
Open Until Filled

Job Responsibilities & Qualifications:

Primary Function:

The incumbent performs highly technical and specialized functions for the Cherokee Indian Hospital Authority. The employee reviews, analyzes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. The primary function of this position is to review the ICD-9-CM, and/or ICD-10-CM, CPT and HCPCS coding for reimbursement. The Business Office functions are a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The Business Office functions also ensure compliance with established guidelines, third party reimbursement policies, US Government regulations and accreditation guidelines.


Education /Experience:
RHIA, RHIT or CCS, CCS-P or CPC certification is preferred or is required within two years’ from date of hire.
A minimal of two years’ billing/coding experience within a healthcare facility is required. 
Enroll in continuing education courses to maintain certification is required.
Twelve to Eighteen months would be required to become proficient in most phases of the job.
Must possess a valid North Carolina driver’s license.

Job Knowledge:
Advance knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify specific clinical findings, to support existing diagnosis, or substantiate listing additional diagnosis in the medical record.
Advance knowledge of medical codes involving selections of most accurate code using the ICD-9-CM, ICD-10-CM, CPT, HCPCS, and the official coding guidelines and for billing of third party resources. Interpret and resolve problems based on information derived from system monitoring reports and the UB04, HCFA-1500, ADA2006 billing forms submitted to third party payer.
Advance knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes. 
Knowledge of and ability to apply the Alternate Resource regulations: P.L. 94-437, Title IV of Indian Health Care Improvement Act , Indian Health Service Policy and Regulations on Alternate Resources, CFR 42-36.21 (A) and 23 (F), and P.L 99-272, Federal Medical Care Cost Recovery Act.
Thorough knowledge of ICD-9-CM, ICD-10-CM, CPT, HCPCS coding terms.
Must, have good math skills and effective communication skills. 
Must, be knowledgeable of the fiscal requirements, policies, and procedures of federal, state, and tribal programs.
Requires knowledge of the business use of computer hardware and software to ensure the effectiveness and quality of the processing and presentation of data.
Requires skill in the use of a wide variety of office equipment including computer, typewriter, calculator, facsimile, copy machine, and other office equipment as required.
Must be able to follow instructions and work independently.