Description

JOB SUMMARY:  The primary purpose of the position is to review both procedural and diagnostic (ICD-10) coding to ensure appropriate billing and insurance regulations are met. This position will be staffed during clinic hours and is remote.

• Have in-depth understanding of coding and compliance rules and regulations.
• Responsible for reviewing provider documentation, coding and posting charges for healthcare services; including Primary Care, OBGYN, General Surgery, Lab/Pathology, Imaging, Podiatry and more.
• Provide coding education and engage with assigned providers.
• Research and communicate governmental and payer-specific rules and regulations to ensure coding compliance.
• Identify and communicate best practices based on provider documentation, insurance payer medical policies and CMS guidelines.
• Review, code and post charges for hospital outpatient and inpatient services.
• Work CCI/LMRP edits, claims manager rules and coding related denials.
• Assist patients and staff with coding and pricing issues.
• Provide support for customer service issues.
• Perform chart audits to assess overall understanding of CMS guidelines and increase clinic reimbursement.
• Attend department meetings, educational seminars, and trainings.
• Other duties as assigned.

• Maintain confidentiality.
• Displays the ability to work independently and multi-task.
• Work effectively under pressure in a fast-paced environment.
• Possess strong analytical, grammatical, spelling a communication skills.
• Attend relevant training sessions, department and employee meetings.
• Abide by clinic protocols, ergonomic recommendations and OSHA standards.
• Maintain a neat and well-groomed professional appearance.

• Is subject to interruptions, imposed deadlines and frequent problem-solving activities.
• May be subject to hostile and emotionally upset patients, staff, and personnel from other agencies.
• Standard Office Environment- with the option to work from home.

• Abide by the ergonomic recommendations of the position.
• Must possess sight/hearing senses or use prosthetic devices that will enable these senses to function adequately.
• Sit for several hours.
• Subject to lifting and carrying supplies averaging 25 lbs. (i.e. cartons of paper, medical supplies, office supplies, etc.).
• Repetitive motions involving use of phone and keyboard.

Qualifications

EDUCATION:      Required:  Certification Professional Coder (AAPC) or Certified Coding Specialist certification (HIMA).

EXPERIENCE:     Minimum: 2 years clinical coding experience with strong E/M coding background.

                            Desired:    2-5 years in primary care and/or multi-specialty experience coding lab services and determining diagnosis codes

KNOWLEDGE:

• Ability to work independently with minimal instruction in a team environment.
• Excellent verbal and written communication skills.
• Ability to prioritize and multi-task.
• Demonstrated PC skills in Word and Excel.
• Maintain positive working relationships.
• Knowledge of Oracle PowerChart and Cerner PM are a plus.