Summary: The Senior Certified Coder/Analyst is primarily responsible for abstracting, coding, billing and accounts receivable functions for all hospital based providers employed by Cook Children's Physicians Network. This position will utilize advanced CPT and ICD coding certifications and proficiencies to monitor daily charges for hospital based providers to ensure accuracy of charge capture, review documentation and perform coding. Senior Certified Coder is also responsible for resolving complex billing issues, claim adjudication denials and performing coding audits to ensure proper procedures are being followed. Senior Certified Coder/Analyst must utilize expert knowledge of payers complex billing rules, diagnostic and procedural code sets in addition to proficiency in the use of computer based medical record systems, coding software and other office technology, such as Microsoft Office Suite. Collaboratively work with representatives from industry and vendor representatives to provide technical advice, support and direction to the revenue cycle process by resolving complex billing problem, communicating with insurance companies and working with provider representatives to maximize reimbursement. Performs other duties as assigned.
High school graduate or equivalent.
At least 5 years' experience in a medical practice or other related healthcare setting with a minimum of three years' of coding experience performing in the capacity of a certified medical coder.
Understanding of diversified insurance plans. Proficiency in basic medical terminology.
Exhibits good interpersonal and communication skills.
Maturity to withstand pressure that may arise in relation to the public, physician or administration interaction or assigned duties.
Licensure, Registration, and/or Certification:
Current coding certification through the American Academy of Procedural Coders (AAPC) or other recognized coding certification organization.
Minimum of two specialty coding certifications required.
Cook Children's Health Care System is a not-for-profit, nationally recognized pediatric health care organization comprised of eight entities – a Medical Center, Physician Network, Home Health company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Health Services Inc., and Health Foundation.Cook Children's Medical Center Based in Fort Worth, Texas, the integrated system has more than 6...0 primary and specialty care offices throughout North Texas. Its service region includes Denton, Hood, Johnson, Parker, Tarrant and Wise counties, with an additional referral area encompassing nearly half the state.Cook Children's traces its roots back to 1918, but throughout its continual change and robust growth, it still embraces an inspiring promise – to improve the health of every child in its region through the prevention and treatment of illness, disease and injury. To live up to this promise, Cook Children's combines the art of caring with the use of leading technology and extraordinary collaboration to provide exceptional care for every child, every day.History – Cook Children's has a rich history of nearly a century of caring for children.Our Promise – Knowing that every child's life is sacred, it is the promise of Cook Children's to improve the health of every child in our region through the prevention and treatment of illness, disease and injury.Companies – Based in Fort Worth, Texas, Cook Children's is a not-for-profit organization that is comprised of eight nationally recognized companies.Community Health Outreach – Cook Children's Community Health Outreach works together with over 150 partner organizations to improve the safety and health of at-risk children through education, disease and injury prevention and support.Clinical Research – Cook Children's is home to a skilled team of research-minded physicians, nurses and health care professionals and administrators who drive our commitment to excellent clinical care and the search for medical advances.Public Relations – Cook Children's Public Relations works with national and local media outlets, produces Cook Children's publications, coordinates special events and helps develop key relationships within the community.Contractor & Vendor Information – Cook Children's contractors and vendors must ensure their employees are knowledgeable about working with our organization.Sponsorship guidelines – Cook Children's sponsors a select number of events that are strongly aligned with its promise to improve the health of every child in the region through the prevention and treatment of illness, disease and injury.