Certified Coding Specialist - Laboratory

Collective RCM is a full-service revenue cycle management company, committed to excellence, integrity and innovation, established to enable healthcare providers the opportunity to navigate and succeed in an increasingly complex reimbursement environment.

Summary of Position:

Collective RCM is seeking a Certified Coding Specialist (CCS) to report to our Plano, Texas, office location. This position will be responsible for reviewing medical documentation to abstract, assign and/or validate ICD-10, CPT and HCPCS coding for Laboratory specialty – which may include molecular, toxicology, general lab, etc.

The CCS will ensure that medical documentation is coded in an accurate and timely manner to achieve maximum reimbursement as well as work closely with the Client and referring physicians/clinics to consistently and accurately translate clinical documentation and medical records into ICD-10, CPT and HCPCS codes. Through these efforts, the individual within this role will identify and report error patterns, resolve errors or issues associated with the coding and billing processes, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors.

The CCS will provide billing analyses of claims with the application of coding standards and federal regulations to ensure correct billing practices. The CCS will also perform bill and chart reviews to identify any variation in quality of billing.

Qualified applicants with specific experience in Laboratory Coding only please apply. Please supply an email address other than indeed when applying for this position.

Functions of Position:

· Review and analyze laboratory requisition forms and result sheets along with any other included medical documentation of the Clinical Laboratory samples in order to properly provide accurate diagnosis and CPT codes for billing purposes and alert Client if any red flags are of concern in the documentation provided. Experience with the following panels is a must:

· Code toxicology panels – Urine Drug Screening and Urine Drug Confirmation

· Code the following panels performed utilizing PCR methodology - Respiratory Pathogen Panel, Urinary Tract Infection, Wound Panel along with Antibiotic Resistance Panels

· Review medical documentation for the purpose of billing in order to abstract, assign and/or validate ICD-10, CPT/HCPCS and modifiers accordingly.

· Ensure accurate, timely and appropriate assignment and/or validation of ICD-10, CPT/HCPCS and modifiers in order to achieve maximum reimbursement and reduce billing errors.

· Apply recommendation of national coding and regulation standards to claims billed. · Monitor documentation turnaround time to ensure billing is completed in a timely manner and that timely filing limits are not missed and/or individual patient claims are not missed.

· Analyze data related to code utilization, CPT code application, denials, reimbursement per contracted terms, etc.

· Provide coding and documentation feedback to providers, clinical team, and revenue cycle team regarding documentation improvement and/or corrective action plans.

· Assist with, create or enhance internal claim and review recommendations.

· Monitor, research, and summarize trends, coding practices, and regulatory changes.

· Identify and report error patterns, resolve errors or issues associated with the coding and billing processes.

· Support revenue cycle team on coding related denials.

· Assist in the design and implementation of workflow changes to reduce billing errors.

Education/Experience/Skill Set:

· Completion of a certified medical coder educational curriculum along with achievement of a Professional Coding Certification - AHIMA (CCS-P); AAPC (CPMA, CPC, CPC-H), or one of the AAPC specialty-specific coding credentials. Laboratory Coding Certifications preferred.

· Minimum 3 years’ experience in laboratory coding – molecular, toxicology, general laboratory, etc.

· Knowledge of laboratory claim billing requirements including HCFA-1500s, CPT codes and ICD-10 diagnoses codes.

· Knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing, with demonstrated ability to interpret such guidelines, along with knowledge of payer reimbursement policies, medical necessity criteria and applicable industry standards.

· Excellent communication (verbal and written), teamwork, training, and presentation.

· Ability to prioritize work and work independently with minimal supervision.

· Responsible and dependable.

· Organized and task oriented.

· Attention to detail and accuracy.

· Strong work ethic and flexibility.

· Analytical skills experience and sound judgment in decision making.

· Self-motivated problem-solver with professional demeanor, high ethics and integrity.

· Demonstrate a commitment to continuous learning and provide support to other coding team members.

· Ability to interact and discuss audit results with providers.

· Ability to use hardware, software and peripherals related to job responsibilities, including MS Office, coding software and medical billing software.

· Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone.

Collective RCM is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

Job Types: Part-time, Contract

Schedule:

• Monday to Friday

Work setting:

• Clinic
• Hybrid work
• Office

Work Location: Hybrid remote in Plano, TX 75093

Job Types: Part-time, Contract

Pay: $24.00 - $26.00 per hour

Expected hours: 20 – 30 per week

Benefits:

• Flexible schedule

Schedule:

• Choose your own hours
• Monday to Friday

Work setting:

• Hybrid work
• Office

Experience:

• Toxicology Panel Coding: 1 year (Required)
• Molecular Coding: 1 year (Required)

License/Certification:

• Medical Coding Certification (Required)

Ability to Relocate:

• Plano, TX 75093: Relocate before starting work (Required)

Work Location: Hybrid remote in Plano, TX 75093