This position is responsible all insurance billing activities for Family Medicine and for assisting with physician/staff education based upon EVMS Medical Group Compliance Guidelines, HCFA Teaching Physician Guidelines, coding guidelines and results of chart audits. Assist with conducting internal departmental mini-audits to ensure inpatient and outpatient medical records contain sufficient documentation to justify the frequency and type of services being billed to carriers and patients.

Assist with conducting regular coding education and training classes for providers and staff.
• Make recommendations on implementing procedures for compliance within the department setting.
• "Work" billing spreadsheet provided by EVMS Medical Group
• Enter inpatient and outpatient charges adhering to carrier regulations.
• Provides feedback to management as to problem areas and when proper information cannot be obtained from providers.
• Responsible for staying abreast of insurance carrier regulation changes and informing providers, management, and staff of such changes.
• Ongoing review of compliance, coding, and billing, literature and guidelines effecting academic medicine and primary care practice.
• Researches and assign the appropriate CPT/ICD-9 & ICD10 code based on the provider's dictation, and other medical records to ensure that the most accurate combination of codes is used for each patient.
• Research and correct all insurance denials received from Medical Group. Includes contacting the insurance company, reviewing patient's chart and encounter form and knowledge of insurance stipulations.
• Research and correct all lab denials for outside lab source (such as Sentara Lab and Labcorp.) Includes reviewing patient's chart - ordering provider's note and patient's problem list.
• Research to complete all missing encounter forms. Includes reviewing patient's chart and note.
• Completes and follows up on missing Information from providers when the information provided does not support the services rendered.
• Audits and reviews the appropriateness of the CPT, ICD-9 and ICD10 coding selections, assuring that the appropriate link between the two coding procedures has occurred.
• Functions as liaison between the providers and EVMS Medical Group Billing Office to communicate and/or educate regarding the appropriate use of the procedural and diagnostic coding process.

Associates degree. Current CPC and/or CPB certification is required or be obtained within one (1) year of employment. One (1) year of experience working with CPT/ ICD-9 & ICD 10 coding. Primary Care coding experience is a plus.