Coding / Reimbursement Specialist III - Revenue Cycle - Clinical Trials

Carolinas Healthcare System Charlotte , NC 28201

Posted 6 months ago

Job Req ID: 195818

Position Number: 00119562

Employment Type: Full Time

Shift: Day

Shift Details: 1st Shift Mon-Fri, 40 hours

Standard Hours: 40.00

Department Name: OPR SPA Clinical Trials

Location: Therapeutic Research and Devel

Location Details: 2709 Water Ridge Pkwy Charlotte, NC 28217

Carolinas HealthCare System is Atrium Health. Our mission remains the same: to improve health, elevate hope and advance healing - for all. The name Atrium Health allows us to grow beyond our current walls and geographical borders to impact as many lives as possible and deliver solutions that help communities thrive. For more information, please visit carolinashealthcare.org/AtriumHealth

Job Summary

Performs duties of moderate to high complexity, analyzes denial data, reports and work queues to depict trends and offer solutions.

Essential Functions

  • Reviews inpatient and/or outpatient medical records to identify the appropriate principale diagnosis and procedure codes, and all other appropriate secondary diagnoses and procedure coes and POA indicator for all diagnosis codes.

  • Subject matter expert in at least one specialty, e.g., oncology, gynecology, surgical coding (not including primary care procedures) and infusion coding including chemotherapy and infusions involving multiple drugs.

  • Assigns CPT and ICD codes in cases of moderate to high complexity.

  • Reads, interprets and assigns CPT codes from provider documentation, e.g., infusion record or operative report.

  • Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered.

  • Appends all modifiers.

  • Ranks CPT codes when multiple codes apply.

  • Assigns Evaluation and Management (E/M) codes.

  • Performs reconciliation process to ensure all charges are captured.

  • Processes automated or manually enters charges into applicable billing system.

  • Researches and analyzes coding and payer specific issues.

  • Processes charges on a timely basis and communicates with team members and practice management on an ongoing basis.

  • Communicates with providers related to coding issues that are of moderate to high complexity. Including face to face interaction, explaining coding rationales, and education with providers.

Physical Requirements

Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending

Education, Experience and Certifications

High School Diploma or GED required. Minimum of 2 years of coding experience required. CPC or equivalent coding credential required. Maintain coding certification (CPC, CCS, RHIT, RHIA). Extensive knowledge of coding, medical terminology, anatomy, and physiology. Extensive knowledge of and the ability to apply the payer specific rules regarding coding, bundling, and adding appropriate modifiers.

At Atrium Health, formerly Carolinas HealthCare System, our patients, communities and teammates are at the center of everything we do. Our commitment to diversity and inclusion allows us to deliver care that is superior in quality and compassion across our network of more than 900 care locations.

As a leading, innovative health system, we promote an environment where differences are valued and integrated into our workforce. Our culture of inclusion and cultural competence allows us to achieve our goals and deliver the best possible experience to patients and the communities we serve.

Posting Notes: Not Applicable

Carolinas HealthCare System is an EOE/AA Employer


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Coding / Reimbursement Specialist III - Revenue Cycle - Clinical Trials

Carolinas Healthcare System