Coding Specialist I

From the mountains to the coast, EmergeOrtho is North Carolina’s premier provider, recognized for offering world-class, comprehensive, and compassionate care serving patients with 59 locations in 28 counties. As the largest physician-owned orthopedic practice in the state and the 6 th in the country, EmergeOrtho’s medical team includes upwards of 170 highly trained orthopedic specialists and nearly as many advanced practice providers. Our subspecialty orthopedic teams offer advanced expertise in conditions of the bones, muscles, and joints. Providing multiple locations, extensive orthopedic services including therapy, and focusing on continuity of care are among the top priorities of EmergeOrtho. Please visit https://emergeortho.com/careers/ for additional information.

EmergeOrtho, P.A. complies with applicable civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We are committed to the core values of Quality, Innovation, Compassion, Community, Education, Integrity, Teamwork, Diversity, and Inclusion. https://emergeortho.com/non-discrimination-notice/

Provides coding services for the practice in physical and occupational 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 during charge entry or during claim resolution the coding manager and/or AR staff.

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

• Code/abstract services for patients for both office and surgical charges using ICD-10 CM/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 department guidelines.
• Interact with AR Specialists and Patient Financial Specialists to ensure appropriate and complete follow-up of patient accounts to maximize reimbursement.
• 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 and physician extender to the 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.
• Research and resolution of claims based on assignment, the process of which could include:
  • Run reports for missing charges in your assigned area.
  • Maintain an appropriate number of claims per hour based on current volume of patient appointments.
  • Communicate with Patient Financial Specialists regarding patient accounts as needed.
  • Utilize resource materials, including coding tools/rules within athenaNet and EncoderPro, to support accurate coding practices.

• High School Diploma or GED required.
• Minimum 1 year of experience related to medical insurance, medical billing, or non-clinical patient support (administrative) in a healthcare or medical practice setting .