Coding Specialist

About the role

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to patients with a mission to enhance vision, advance eye care, and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, spanning the eye care continuum.

Responsibilities

• Evaluate medical record documentation and charge-ticket coding to optimize reimbursement by ensuring diagnostic and procedural codes, and other documentation, accurately reflect and support outpatient visits via data compliance with legal standards and guidelines.
• Review medical records and both identify and address any documentation or charge discrepancies.
• Interpret medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-9-CM and CPT codes.
• Perform edit checks on data entered prior to transmittal and correct errors as indicated.
• Research, analyze, recommend, and facilitate plans of action to correct discrepancies and prevent future coding errors.
• Provide technical guidance to physicians and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and codes that do not conform to approved coding principles and guidelines.
• Collaborate with RI Specialists and the Denials team on reviewing state and federal Medicare reimbursement claims, for completeness and accuracy, before submission to minimize claim denial.
• Assist lead or supervisor in educating and advising staff on proper code selection, documentation, procedures, and requirements.
• Develop and update procedure manuals to maintain standards for correct coding, to minimize the risk of fraud and abuse, and to optimize revenue recovery.
• Read bulletins, newsletters, and periodicals, and attend workshops to stay abreast of issues, trends, and changes in laws and regulations governing medical record coding and documentation.
• Participate in team meetings and activities to support the goals of the team and department.

Requirements

• Knowledge of ICD-10-CM and CPT coding guidelines, medical terminology, and both state and federal Medicare reimbursement guidelines.
• Experience with the utilization of modifiers and other coding rules to include the AMA and other coding organizations.
• Excellent written and verbal communication skills to prepare reports and related documents and to maintain working relationships with physicians and other staff.
• Ability to apply and understand payer requirements.
• Ability to prioritize and resolve multiple tasks with excellent problem-solving skills.

Qualifications

• Minimum education: High School Diploma or G.E.D.
• Minimum experience: 2+ years of medical coding experience OR completion of A.A. or A.S. in medical coding and billing, medical administration, or a related field.
• Minimum credentials: CPC, RHIT, ART, or CCS coding credentials.

Skills

• Proficient in Microsoft Excel, Word, PowerPoint, and Outlook.
• Experience with EHR software systems.

Physical Requirements

• Regularly required to talk and hear.
• Occasionally required to stoop, kneel, crouch, or crawl.
• Must frequently lift and/or move up to 10 pounds.
• Specific vision abilities required include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.