Bryan Heart Coding Specialist

Overview

Coding Specialist II-Bryan Heart Billing & Collections

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General Summary

Responsible for accurate and compliant assignment of CPT and ICD 10 codes supported by provider documentation in the medical record utilizing the current year ICD-10 and CPT manuals to ensure optimal reimbursement.

Responsibilities

• Commits to the mission, vision, beliefs and consistently demonstrates our core values.
• Adheres to all relevant Bryan Health / Bryan Heart policies and procedures.
• Accurately assigns and sequences diagnosis and procedure codes to arrive at the correct Ambulatory Payment Classification assignment - utilizing provider supporting documentation.
• Maintains coding certification by performing continuing educational requirements as defined by certifying body / organization.
• Maintains thorough understanding of Government and commercial payer documentation, coding and reimbursement guidelines, CCI edits, MUEs, NCDs and LCDs.
• Achieves and consistently maintains departmental productivity / performance goals and metrics.
• Complies with Bryan Heart Coder Audit / Competency Program.
• Analyzes, researches and performs payer follow up tasks specific to coding denials (including but not limited to bundling / medical necessity / non-adherence to payer coding and reimbursement guidelines).
• Assists with monitoring payer denial trends and development of denials management process.
• Regularly advises direct report supervisor / director of concerns including provider documentation content and timeliness to complete, payer performance, system functionality and any other identifiable barriers to performance thus negatively influencing the organizational goals and metrics.
• Provides timely feedback to providers when identifying documentation concerns or inaccurate assignment of procedure codes.
• Actively participates in meetings to build a cohesive team by responding to inquiries, making recommendations, sharing observations and respecting team members input.
• Assists as requested with auditing activities.
• Reviews and reports new, deleted, or inactivated procedure codes to appropriate team members.
• Participates and completes mandatory annual training as assigned by Bryan Heart / Bryan Health.
• Develops and fosters relationships with providers and clinical support staff.
• Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.
• Participates in meetings, committees and department projects as assigned.
• Performs other related projects and duties as assigned.

Education And Experience

High school diploma or equivalency required. Certification as a Certified Coding Associate (CCA) required. Certification as a Certified Coding Specialist (CCS or CCS-P) or Certified Professional Coder (CPC) preferred. Minimum of five (5) years coding experience in a medical environment required. Cardiology / Cardiothoracic / Vascular coding experience preferred.

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