Medical Coding Specialist

Job Description

Under general supervision the Medical Coding Specialist, performs daily charge review of visits, diagnosis, radiation oncology or surgeries for accurate level and coding. Responsible for input charges into practice management system or EMR. The Medical Coding Specialist may also be assigned to audit physician, nurse practitioner and clinical oncology staff documentation for correct coding of CPT, ICD-10, HCPCs, and modifiers.

Responsibilities

• Keeps informed regarding current coding regulations, auditing, professional standards and company/department policies and procedures as it applies to the field of oncology and effectively applies this knowledge.
• Review operative reports and other supporting documentation to assign appropriate CPT and ICD10 codes.
• Perform audit and entry of charges into EMR system and/or Practice Management System.
• Works with other coders in the department to assist with difficult cases.
• Aids practice leadership to analyze data, identify issues, reach conclusions, and propose strategies for resolution of complex coding issues.
• Communicates effectively with practice leadership regarding coding and documentation issues by assisting in the preparation of reports and memoranda regarding audit results and coding compliance matters.
• Aids in the development and review of detailed audit programs and reports to improve audit effectiveness and efficiency, as needed.
• Aids in the development of procedure manuals related to coding and billing compliance.
• Demonstrates outstanding work ethic and works cooperatively with all team members and management with a can-do spirit and team attitude.
• Reviews charges/claims for accurate coding of ICD10, CPT and HCPCS codes.

Required Qualifications

• Must have a Professional coding certification
• Minimum of 4 years coding experience preferred
• 2 years’ experience performing chart audits or assignment of appropriate CPT and ICD10 codes through documentation review, in a physician practice/hospital environment required.
• CPC Certification through the AAPC preferred
• Knowledge of Medical Oncology/Radiation /Surgery coding highly preferred
• Must be willing and able to lift up to 25 pounds
• Must be willing and able to travel to satellite clinics when necessary.

Essential Competencies

• Attendance is an essential job function
• Ability to travel to various sites throughout Middle Tennessee to conduct audits of records
• Knowledge of government, legal and regulatory provisions related to collection activities
• Knowledge of government programs, i.e., Medicare and Medicaid
• Knowledge of insurance company’s policies and procedures
• Knowledge of CPT, ICD-9, HCPCS coding
• Knowledge of anatomy and medical terminology
• Ability to prioritize work and manage time efficiently
• Creative thinking skills, hands on problem solving skills and ability to analyze and respond to data
• Effective communication skills at all levels within organization and excellent customer service skills.