Medical Coding Specialist

Position Summary

Responsible for reviewing medical records for compliance with coding and documentation requirements.

Job Responsibilities

• Performs ongoing prospective coding and documentation chart reviews for physician services to ensure that the coding supports the services billed.
• Selects and assigns the appropriate ICD-10, CPT and HCPCS codes, based on chart review documentation.
• Enters charges into the practice management billing system, ensuring to meet productivity and quality-based departmental benchmarks.
• Performs charge entry batch quality assurance.
• Reviews and resolves charge router and charge review edits, as needed.
• SUBMITs queries to physicians, as appropriate, for documentation clarification.
• Participates in internal and external audits of billing operations and activities.
• Participates in annual and on-going mandatory compliance training.
• Fulfills Continuing Education Units necessary to maintain certification status.
• Keeps informed of changes in policy within the field.
• Stays abreast with compliance on federal, state health care laws, regulations and rules.
• Reports any differentiation from institutional or departmental procedures.

Education

• High School Diploma

Experience

• Approximately 2 years of experience in physician billing, CPT, ICD-10 and HCPCS Coding.
• Prior experience working with an eMR system.
• Working knowledge of federal and state reimbursement regulations.
• Knowledge of third party insurance billing policies and procedures.

Licenses and Certifications

• Certified coder (CPC, CCS-P)

Education and Training

• Continuing Education Units necessary to maintain certification status.

Working Conditions/Physical Demands

• Standard office work