Position: Medical Coder
The Coding Specialist (CS) will be responsible for the quality and accuracy of CPT and ICD-10 assignment/submission for multiple practice providers. The CS will be responsible for feedback regarding documentation and billing guidelines to providers and front-end users. They will need to obtain a clear understanding of the department’s charge capture workflow, and assist with improvements that will directly impact the timeliness of claim submissions and their adjudication. They will work in conjunction with the CEO and Revenue Cycle Manager to maximize the department’s revenue stream.
• Assist in the coding process for multiple specialties
• Validate and determine appropriate coding levels, procedures and diagnosis codes by obtaining and reviewing clinical documentation while following appropriate CPT and payor guidelines
• Compare and review charge encounter, both manually and system generated, to clinical documentation to ensure that all charges for office visits and procedures have been accurately documented and captured
• Ensure that documentation and coding supports billings to prevent denials and underpayments
• Follow-up with providers regarding missing clinical documentation which is required to complete accurate coding and billing
• Stay current with educational materials and policies/procedures to assist staff and providers with the new regulatory or payer policies
• Identify and assist with implementation of documentation and revenue enhancement opportunities
• Assist with the development of educational material and policies and procedures to assist providers and staff with understanding new regulatory or payer policies
• In conjunction with the Revenue Cycle Manager, identify relevant charge master updates
• Responsible for resolving any coding related errors and denials that are identified by RCM team as part of the revenue enhancement initiatives
• Continuous review of revenue cycle with the CEO and Revenue Cycle Manager
• Participate in departmental projects as needed
• Participate in education programs to maintain up to date coding skills
• Working with Revenue Cycle Manager, coordinate random chart audits to ensure appropriate documentation, coding and billing and provide feedback to key personnel.
• HS/GED required, Associates degree preferred.
• Certified Professional Coder (CPC) Certificate
• 3 years of relevant coding experience is required
• Business office or patient accounts experience a plus
• Exposure or participation in documentation improvement programs is a plus
• Excellent written and oral communication skills and computer skills are essential
• Must be organized and capable of multi-tasking various projects and developing and adjusting priorities as necessary
• Ability to prioritize the scope of work in line with the department goals
• Knowledge of CPT documentation guidelines as well as the CMS Medicare Claims Processing Manual.