Medical Coding Specialist 2

Overview

Reviews assigned providers' procedure and diagnosis codes, and makes coding changes as necessary. Provides timely feedback to providers regarding documentation guidelines, coding, and audits. Performs other duties as assigned. May be asked to work weekends and reasonable amounts of overtime when necessary.

Responsibilities

Essential Duties and Responsibilities

• Reviews, analyzes, and interprets provider documentation with regards to procedure and diagnosis code selection.
• Performs audits of provider coding and documentation to make recommendations for improvements and enhancements.
• Maintains a close working relationship with assigned providers and medical office, frequently querying the provider when coding discrepancies arise.
• Researches any coding inquiries the provider or medical staff may have, and presents findings to them.
• Reviews hospital, clinical, and surgical documentation and the assigned diagnosis and procedure codes, releasing charges within the Epic system. Identifies discrepancies between the provider code selection and the medical record documentation; makes appropriate corrections, and presents findings and education to the provider.
• Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare & Medicaid Services (CMS) and contracted payers.
• Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.
• Works with billing partners in developing efficient coding processes and researching denials.
• Responds to customer concerns through coding reviews requested by other departments.
• Conducts provider coding orientation and education sessions and documents all information presented.
• Maintains an in-depth knowledge of Epic ambulatory and hospital modules.
• Works as a team to achieve productivity goals.
  
  
  

Culture of Excellence Behavior Expectations

To perform the job successfully, an individual should demonstrate the following behavior expectations:

Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.

Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.

Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.

Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.

Education And Experience

High School graduate or equivalent

Two years of experience coding professional services in multiple specialties

Certification and Licensure

Certified Professional Coder (CPC) or other equivalent coding certification required

Skills And Abilities

Problem solving skills

Excellent written/oral/interpersonal/communication skills

Analytical skills

Special Physical Demands

The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.

While performing the duties of this job, the partner is regularly required to talk and hear. Eyesight to identify numbers, folders, colors, and computer printouts. Speech to communicate one-on-one and over the telephone. Manual dexterity to operate keyboards, mouse and telephones. Prolonged sitting; use hands to finger, handle, or feel and reach with hands and arms. The partner is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The partner must occasionally lift and/or move up to 25 pounds.

Level of Supervision

N/A

Supervises

N/A