The Coding Supervisor manages professional billing coding staff, ensuring accurate clinical documentation and compliance with regulatory standards. They analyze billing data to identify revenue opportunities and provide education to providers regarding coding trends and quality metrics.
The Telehealth Staff Nurse provides remote nursing care and triage for diverse patient populations using telecommunications technology. Responsibilities include determining appropriate levels of care, providing home care instructions, and managing medication refill requests.
The Coding Specialist performs inpatient hospital billing by assigning accurate ICD codes and DRGs to diagnoses and procedures. They also abstract clinical data, interact with providers for documentation clarification, and maintain coding accuracy standards.
The Prior Authorization Specialist coordinates pre-authorizations for patients by verifying medical necessity and insurance coverage in accordance with payer requirements. They also serve as a subject matter expert for the team, resolving complex authorization issues and assisting with denial appeals.
The specialist confirms patient demographic and insurance information to ensure accurate billing and benefit eligibility. They also manage prior authorizations, provide price estimates, and assist patients with financial counseling resources.
The role involves configuring and maintaining Epic Willow pharmacy applications and resolving high-complexity technical issues. It also requires collaborating with end-users and mentoring team members to optimize system functionality.
