Medical Coding Specialist

Medical Coding Specialist

Position Summary

The Medical Coding Specialist reviews provider medical records for documentation and coding compliancy with federal and state laws and regulation. Has a thorough knowledge of medical terminology, CPT-4, HCPC and ICD-9 codes.

Education

Associates of Health Information Administration - Preferred

Experience

3 Years medical coding experience - Required

License & Certification

Certification by American Health Information Management Association (AHIMA) CCS; or certification by the American Academy of Professional Coders (AAPC) CPC - Preferred

Core Job Functions

Research, develops and implements standardized process for quality monitoring of coding.

Proactively identifies areas of opportunity to improve upon provider coding. Implements innovative ideas and process changes.

Monitors and evaluates compliance with documentation standards to identify trends, issues, risk areas and opportunities of education and process improvement. Implements educational programs based on educational needs found thru audits, new technologies, new payor rules and coding guideline changes.

Assist the providers, billing specialist and other departments in clarification of coding regarding reimbursement issues to resolve claim errors and assure clean claim submission.

Assist with working claims held due to coding issues.

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