Trillium Health, a Federally Qualified Health Center Look-Alike, is a community health center offering access to affordable care for all, with a special focus on meeting the needs of LGBTQ people, communities of color, and underserved populations.

Nationally recognized for outstanding patient-centered care, the team at Trillium Health provides a wealth of knowledge and experience. Our expansive array of services, including testing and treatment, laboratory services, primary and specialty care, and an on-site pharmacy, makes it easier for patients and clients to receive the complete care they need, all in one place.

Our authentic commitment to diversity and inclusion is evidenced through our hiring practices, our employee programs, and our compassion for everyone we serve. Based in downtown Rochester, with satellite locations in Bath and Geneva, and MOCHA centers in Buffalo and Rochester, Trillium is deeply invested in building community. We proudly sponsor many other nonprofit organizations throughout the area and participate in a wide range of community events.

Trillium’s employee-centered company culture and exceptional benefits have contributed to impressive growth in recent years, raising our staff total to more than 250. We hope you will consider joining us on this upward path and becoming a part of the Trillium Health family.

We are currently recruiting for a Billing and Coding Specialist.

Key Job Responsibility Areas:

Coding/Auditing

• Evaluate medical record documentation and encounter coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit, and to ensure that data comply with legal standards and guidelines.
• Interpret medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct ICD 10, CPT codes and HCPCS II.
• Review Medicaid and Medicare reimbursement claims before submission for completeness and accuracy and to minimize claim denial.
• Assist staff in making changes to the electronic medical record master file as required.
• Provide technical guidance to clinical providers and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to approved coding principles/guidelines.
• Educate and advise staff on proper code selection, documentation, procedures and requirements.
• Identify training needs, prepares training materials, and conducts training for clinical providers and support staff to improve skills in the collection and coding of quality health data.
• Measure and report trends in provider coding

Billing Process

• Evaluate encounters for completeness and ability to be billed.
• Submit third party claims to payers for processing
• Work denials and rejections from clearinghouse and payers
• Resubmit denied claims as necessary
• Patient contact to resolve billing problem
• Aggressively follow-up on collection of aged accounts receivable
• Interact with Case Management staff on insurance problems
• Compliance activities as directed

Payment Processing

• Post third party remittances
• Post payments received on patient and client accounts to eMDs, Medent and AIRS in a timely manner.
• Work denials and rejections from payers
• Reconcile industry-specific applications, i.e., eMDs, AIRS, Medent, Scriptpro, TPMS, FundEZ, to general ledger and resolve differences in a timely manner

Credentialing

• Maintain Provider insurance panels and credentialing
• Assure all payer contracts are up to date and maintained

Cash Receipts

• Post cash receipts (electronic) to the general ledger in a timely manner.
• Prepare Bank Deposit
• Balance deposits from the Pharmacy and Clinic to the general ledger

Miscellaneous

• Provide support within the Finance dept. in the event of another staff member's absence.
• Requires the ability to relate to people of diverse backgrounds, cultures, races, sexual orientations and gender identities or expressions.
• Responsible for maintaining confidentiality of all patient, client, proprietary and protected information.
• Miscellaneous filing, copying, faxing, etc. as needed to support Finance staff.
• Employees are accountable for meeting performance standards of their departments.  They participate in compliance audits and quality improvement plans.
• Other job duties as assigned by supervisor.

Qualifications

• Associates' degree in a relevant field plus 5 years' experience in medical billing/coding. Valid Coding Certification required (CPC, CCS, CMC). Proficiency in Microsoft Excel and Word required. Must have a positive attitude, good attention to detail, be willing to take initiative and exercise good judgment. Must be reliable, highly organized and able to prioritize and juggle a variety of activities.

Apply online at https://www.trilliumhealth.org/en/291/careers