Revenue Cycle Certified Coder

Job Summary

The Coding Specialist reviews superbills and the corresponding medical record documentation and assigns appropriate CPT, HCPCS, modifiers, and ICD 10 codes and post charges in order to achieve maximum reimbursement in accordance with OSNI protocols and procedures along with CMS and private payer guidelines.

Responsibilities

• daily charge posting after assignment of appropriate billing and diagnostic codes
• review of first level rejected claims in practice management
• use of hospital portals to obtain operative reports and patient demographics
• scanning of completed work into SRS
• querying physicians and ancillary medical staff when medical record requires clarification
• ensuring medical record is amended by provider when appropriate
• participating in internal provider coding review sessions

Qualifications

• High school diploma or an equivalent combination of education and experience
• RHIT, CPC, or CCS is required
• Associate degree or higher in coding or health information management, accounting or business administration highly desired
• Data entry skills (50-60 keystrokes per minutes)
• Past work experience of at least one year within a healthcare setting, an insurance company, managed care organization or other financial service setting, performing coding or billing functions is required
• Knowledge of insurance and governmental programs, regulations and billing processes (e.g., CMS, Anthem, UHC, etc), managed care contracts and coordination of benefits is required
• Thorough working knowledge of medical terminology, anatomy and physiology, medical record coding (ICD-10, CPT, HCPCS), and basic computer skills are required
• Excellent communication (verbal and writing) and organizational abilities
• Interpersonal skills are necessary in dealing with internal and external customers
• Accuracy, attentiveness to detail and time management skills are required