MEDICAL CODING SPECIALIST

BASIC FUNCTION

Job Description

DEPARTMENT

Finance

Job Title

MEDICAL CODING SPECIALIST

RESPONSIBILITIES

• Analyzes provider documentation carefully to know the diagnosis and assigns every item with specific codes.
• Assigns codes for diagnosis, treatments and procedures according to the appropriate classification system.
• Reviews claims data to ensure assigned codes meet required legal and insurance rules and that required authorizations are in place prior to submission.
• Evaluates and re-files appeals for patient claims that were denied.
• Ensures correct patient allocation is set.
• Voids any duplicate charges or charges entered in error.
• Identifies and reports error patterns.
• Notifies coding supervisors of missing orders or documentation clarification.
• Ensures timely and efficient billing of all electronic claims submission.
• Accurately enters payment and adjustments in the A/R system.
• Collections health information as documented by medical providers and codes them appropriately.
• Consults medical providers for further clarification and understanding of items on patient charts to avoid any misinterpretations.
• Provides accurate account information to patients about their A/R accounts and makes any necessary corrections.
• Complies with HIPPA, federal regulations, and Family Care Health Centers policies.
• Periodic Duties: Contributes to Health Center community health activities outside of regular job responsibilities. Participates in Health Center staff problem solving groups. Attends and participates in department meetings, etc. as assigned. Performs other duties as assigned.

QUALIFICATIONS

• High School Diploma or GED Certificate required.
• Associate Degree or Certificate in Medical Coding, health information technology or related field preferred.
• Certified Professional Coder (CPC) required.
• Coding certification from AHIMA or AAPC preferred.
• Two plus (2+ years of medical coding experience and/or training or the equivalent combination of education and experience preferred.
• Respect for and maintenance of client and staff confidentiality is required.