Certified Coding Specialist- AZ- Clinic Finance

About the role

The Certified Coding Specialist protects and recovers the clinic’s patient reimbursement by acting as a coding/billing resource for all MWU clinics, educating providers, monitoring accounts receivable, and collecting delinquent accounts. This position will report to the Assistant Manager of Patient Accounts.

Essential Duties And Responsibilities

• Reviews coding used for Multispecialty Clinics and Eye Institute to ensure coding is in accordance with legal requirements, compliance standards, official coding rules, guidelines and definitions
• Participate in provider education on proper documentation of services provided, coding and billing issues, charge capture process and reconciliation of charges as it relates to E & M coding guidelines
• Train and educate finance staff on billing and coding
• Participate in clinic coding assessments/audits, both internal and with external vendors
• Participate in the development of coding policies and procedures as needed
• Identify key issues and take appropriate action to ensure revenue maximization on individual accounts
• Ensure all documentation (ABNs, letters of medical necessity, Medicare Wellness forms, etc.) are on file and properly filled out for patients when required
• Research coding/billing guidelines for new specialties
• Work in conjunction with the Assistant Manager and Manager of Patient Accounts to help reach and maintain financial and accounts receivable goals for the clinic
• Assist in implementing changes directed by regulatory agencies
• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, and participating in professional organizations

Qualifications

• High school diploma or GED required
• Associate degree preferred
• A minimum of 3-5 years of coding experience in a medical office setting and a current Certified Professional Coder (CPC) certification required
• Expert knowledge of ICD-10, CPT, HCPCS, modifiers, and medical terminology required
• Experience working with Medicare, Medicaid, Third party payers is also required
• Expert in interpreting LCD and NCD coverage criteria
• Knowledge of the revenue cycle, charge master, manual book coding/computer coding experience
• Excellent interpersonal, communication and customer service skills are required
• Strong analytical and problem solving skills
• Excellent verbal and written communication skills are a must
• Must be able to work independently and multi-task working on several projects at once
• Computer proficiency in MS Office (Word, Excel, Outlook) is required
• Experience using medical practice management software is required

Supervisory Responsibilities

This position has no supervisory responsibilities.

Education And/or Experience

Education and/or experience as outlined in the Qualifications section.