Medical Coding Specialist

JOB TITLE: Medical Coding Specialist

DEPARTMENT: Healthcare Vertical: ACS

REPORTS TO: Manager and/or Area Manager

SUPERVISORY RESPONSIBILITIES: no

JOB LOCATION: Varied

TRAVEL: no

SUMMARY OF POSITION: Under the directions of the Coding Services Supervisor and Manager, this position will be responsible for CPT and ICD-10 coding and ensuring accuracy and maximum reimbursement and minimizing denials.

ESSENTIAL DUTIES & RESPONSIBILITIES:

• Assigns accurately and sequences appropriately ICD-10 and CPT codes and all applicable modifiers

• Contacts clients as appropriate when documentation in the medical record is inadequate, ambiguous or unclear for coding purposes.

• Monitors regulatory and payer changes as they apply to diagnostic and procedure coding

• Researches and resolves coding related system edits, payer rejections and insurance denials.

• Identify system edit, payer rejection and insurance denial trends for client policy and procedure improvement.

• Maintains up to date knowledge of the current changes of coding practices by continuing education and reading resource material.

• Other innovative and progressive duties as assigned

MINIMUM QUALIFICATIONS (EDUCATION AND EXPERIENCE): High School diploma or GED

PREFERRED QUALIFICATIONS (EDUCATION AND EXPERIENCE):

A successful candidate must have proficient knowledge/capabilities in the following areas:

• Nationally recognized coding credential including, but not limited to CPC, COC, CCS, CCS-P, RHIA or RHIT through AHIMA/AAPC.

• High school diploma or equivalent required.

• 1-3+ years coding experience required, and outpatient physician and/or multi-specialty coding experience, preferred.

• Understanding of all or a combination of ICD-10, CPT, HCPCS, modifiers, medical terminology and HIPAA compliance.

• Possess strong written and verbal communication skills to communicate effectively with individuals at all levels of the organization.

• Ability to work under general supervision

• Ability to work in a fast-paced department and handle multiple tasks, work with interruptions, and deal effectively with confidential information.

• Possess excellent telephone etiquette, presentation skills and problem resolution skills

• Computer skills including Microsoft Office Suite

• Must be highly organized and detail-oriented

• Understands fully the requirements to meet HIPPA regulations. Must treat all patient information and data with complete confidentiality and takes all precaution to secure this information.

• Cooperates fully in all risk management activities and investigations for QM purposes.