Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations.

Summary:
Performs all registration functions. Establish diagnosis (ICD-9) codes for all charges. Maintains database of patient information and reports updates to management, medical records, and therapists. Ensures compliance with state requirements regarding evaluation and treatment process. Covers in other business functions and trains staff in basic coding. Provides support to the clinical staff.

Responsibilities:
1. Performs registration functions utilizing Invision system.
2. Verifies insurance coverage and benefits with designated insurance company or managed care provider, per payer guidelines/standards.

3. Manages department holds to reduce department charge back to a minimum with continuous contact with Physician Offices.

4. Obtains via telephone and/or fax the appropriate paperwork from insurance companies to obtain authorizations and/or re-certified visits. Notes authorization in charts for follow up.

5. Follows up with patients to explain insurance benefits and provide assistance.

6. Provides in-services to staff concerning insurance changes and updates with Invision registration system.

7. Assigns diagnosis codes (ICD-9) to initial evaluations. Enters initial ICD-9 codes into Invision system, allowing bills to drop timely.

8. Enters patient information and ICD-9 codes into workstation database.

9. Assigns ICD-9 codes from database to recurring accounts on billing exception report received from ITG, allowing bills to drop for billing and payment.

10. Maintains/updates database to provide accurate information to management, medical records and clinicians.

11. Generates queries/reports from database when requested by management, medical records, and therapists.

12. Logs, tracks and reports on state-mandated "Evaluate and Treat" scripts to ensure compliance. Logs and tracks corporate compliance issues as assigned.

13. Maintains accuracy of ICD-9 quick reference list for clinical staff at all outpatient sites.

14. Provides continuous communication between department, consumers and MD offices.

15. Provides coverage for charge capture, medical records, insurance receipts and visit scheduling.

16. Fulfills all compliance responsibilities related to the position.

17. Performs other duties as assigned.
Other information:
Required: Data entry and Invision required. Knowledge of medical terminology, anatomy & physiology, database management, billing procedures and medial records. Basic knowledge of Medicare guidelines to maintain POC compliance & perform monthly Medicare audits.
Minimum Experience: one year

Desired: Medical terminology certification and medical coding certification preferred/desired.
Location: Danbury-235 Main St

Work Type: Full-Time

Standard Hours: 40.00

FTE: 1.000000

Work Schedule: Day/Eve 8

Work Shift: Monday - Friday from 8:00am to 4:30 with occasional early morning and evening as needed.

Org Unit: 186

Department: Phys Med - Main St

Exempt: No

Grade: U4

Education:
Essential:
* HS Graduate or Equivalent
Working conditions:
Essential:
* Significant manual skills / motor coord & finger dexterity
* Little or no potential for occupational risk
* Medium to Heavy effort. May exert up to 35 lbs. force
* Generally pleasant working conditions.

EOE, including disability/vets.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.