Coding Specialist II

FT Remote - Work from Home

Provides coding services for the practice, including office and therapy charges using the patient’s medical record to accurately code and bill for all supported medical services.

This employee serves as an information resource and guide to providers, clinical staff, practice managers, coding operations managers, process improvement team members, and other leadership.

The coding specialist would submit any issues or trends found within documentation of the providers’ documentation by performing random chart audits, resolving claims by researching, contacting payers, or writing appeals.

Responsibilities include, but are not limited to, the following :

• Code / abstract services for patients for office charges using ICD-10 CM / PCS and CPT / HCPCS coding systems.
• Accurately and efficiently access practice information systems to secure and assemble all necessary physician and physician extender records to accurately code and bill medical services.
• Assemble and input coding results into the current practice management billing system to expedite compliant and proper billing.
• Provide training, guidance, and oversight to staff less experienced in coding guidelines. Interact with AR Specialists and Patient Financial Specialists to ensure appropriate and complete follow up of patient accounts to maximize reimbursement.

Serve as an information resource and guide to clinicians, champion the need to change coding behaviors and serve as subject matter expert Communicate with providers, practice managers, coding manager, VBO Director, process improvement team, and other leadership, to include attendance at departmental / interdepartmental meetings.

• Submit any issues or trends found within the documentation of a physician or physician extender to assigned coding manager and practice manager.
• Monitor and execute work against the assigned and team associated Custom Claim Worklist(s), relational AR Worklist(s), reporting, projects, or team / department goals.
• Perform chart audits to ensure that clinical documentation substantiates the evaluation and management, procedures, and modifiers selected following Federal, State, and system documentation and coding requirements.
• Research and resolution of claims based on assignment, the process of which could include :
• Coding and charge-entry based and associated responsibilities (CPC).
• Run reports for analysis, trending, a subdivision of work or distribution based on direction (both self and managerial) as needed to communicate data of interest, trends of concern, or a need.
• Assist in the resolution of Zero-Pay Worklist, Fully Worked Receivables, complete special project work, review and respond to adjustments / payment data with approval (or initiate appeal) communicate trends and root issues through proper lines of reporting.
• Communicate via phone or email with Patient Financial Specialists regarding patient accounts as needed.
• Maintain CEUs and credentials (CCS, CPC, RHIA, or RHIT required).
• Utilize resource materials, including coding tools / rules within athenaNet to support accurate coding practices.
• High School Diploma or GED and CPC or CCS credentials required.
• Prior coding experience is preferred.
30+ days ago