Coding Support Specialist

JOB SUMMARY:   The Coding Support Specialist is responsible for the review and follow-up of incomplete inpatient and outpatient claims. Specific job functions include obtaining missing documentation needed for final coding including Discharge Summaries, Pathology Reports, Operative Reports, etc.; provider follow-up on unanswered documentation clarifications, and any additional documentation needed for appropriate ICD-10-CM/PCS, CPT and HCPCS code assignment. Ensures timely review and completion of claims edits within Epic and SMART systems. The Coding Support Specialist ensures DNB goals are maintained by working closely with coding team, CDI, providers, and Patient Financial Services (PFS) to achieve completion of claims. Provides assistance in coding work queues, inpatient and outpatient, as needed. Conducts coding audits as needed including PEPPER, corporate compliance, etc. Works closely with Coding Supervisor to develop strategies to reduce turn-around time for final billing and medical record completion. Knowledge of payor specific rules and regulations, CMS LCD/NCD index, and revenue cycle processes. Provides coding guidance to other Blue Ridge facilities and departments. Meets established quality and productivity standards. Performs other duties as assigned.

QUALIFICATIONS:

Education:      Associates or Bachelor’s degree in a healthcare-related field required.

Experience:     Minimum 3-5 years coding experience in acute care setting preferred

License/Registration:  Credential required (one or more):   CCA, RHIT, RHIA, CCS, CPC-A, or CPC, CDIP

Other:    Knowledge of ICD-10-CM/PCS and CPT-4 classification systems/coding guidelines;  

               Knowledge of DRG and APC reimbursement systems;  

                  Knowledge of Epic system including billing and claim edits; 

                  Knowledge of Optum Encoder system preferred but not required;                                                       

               Excellent and positive interpersonal, verbal and written communication skills;                  

               Proficient with Microsoft office applications;                                                          

                   Must able to think critically and creatively to positively problem solve;

                   Must complete tasks with integrity and compliance

                   Must be able to work independently;

                   Must have strong organizational and time-management skills;

                   Must have outcomes that comply with all applicable coding and billing rules, regulations, laws, etc.

TYPICAL PHYSICAL DEMANDS: Corrected vision and hearing to normal range and ability to discern color; eye-hand coordination and manual dexterity.  Full range of body motion including sitting for prolonged periods of time and lifting, carrying, pushing or pulling objects weighing up to 10 pounds; repetitive motion.