Coding Specialist -Remote

POSITION SUMMARY

• Under the general direction of the Director of Revenue Integrity and the direct supervision of the Coding Supervisor, this position is responsible for coding for Elliot s professional practices. This position is responsible for ensuring the appropriate diagnostic codes, CPT codes and modifiers according to CMS coding Guidelines and CMS Correct Coding. Coding, auditing and entering all surgeries and special procedures performed in the office, ambulatory surgical center, and hospital setting using correct CPT & ICD-10 codes.

PRIMARY DUTIES AND RESPONSIBILITIES

Employees are expected to work consistently to demonstrate the mission, vision, beliefs, core values and standards of behavior of the organization.

• Reviews documentation for appropriate diagnosis and procedure code assignment of professional encounters (EPN, or EPS) using the ICD-10-CM, CPT, and HCPCS coding systems.

• Adheres to outside regulations and requirements, state reporting mandates, and provides coding to minimize the number of days in receivables.

• Meets or exceeds productivity and quality standards.

• Communicates with Physician practices for documentation needed for accurate coding and billing. Provide real-time feedback to providers as it pertains to proper coding and clinical documentation of services performed.

• Seeks clarification from the physician via face-to-face or via staff messaging when documentation is absent, ambiguous or contradictory.

• Adheres to the Standard Operating Procedure for Provider-Coder Discrepancies.

• As per the SOP, provides feedback to physicians regarding appropriate documentation for coding. Refers to coding supervisor and coding educator any documentation trends that require provider education.

• Maintains positive working relationships with physicians, clinical staff, management, and co-workers.

• Works independently and takes initiative to identify opportunities to maximize efficiencies.

• Uses root-cause analysis to recommend process improvements relating to epic work queue and Epic process flow

• Participates in ICD-10 readiness initiatives.

• Participates in new provider education as determined by coding leadership.

POSITION QUALIFICATIONS

• Education:

• Minimally Required:

• High school diploma or equivalent required.

• Preferred:

• Licensure/certification:

• Minimally Required:

• Current AHIMA or AAPC Coding Certification(s) CCS, CCS-P, CPC, or COC required

• Preferred:

• Experience:

• Minimally Required:

• Three (3) to five (5) years of multi specialty coding experience required.

• Preferred:

• Experience with Epic, 3M encoder, and Microsoft Office applications preferred

• Knowledge:

• Minimally Required:

• Maintains an in-depth knowledge of the software system in areas related to coding.

• Maintains coding credentials through participation in continuing education activities.

• ICD-10-CM, CPT, and HCPCS coding knowledge.

• Knowledge and understanding of coding edits.

• Understanding of payer billing rules including provider based billing.

• Preferred:

• Skills:

• Minimally Required:

• Possesses effective and professional written and oral communication skills.

• Uses computers and related software proficiently.

• Preferred:

• Abilities:

• Minimally Required:

• Ability to code high severity and highly complex cases including, but not limited to surgeries and/or procedures.

• Accepts constructive feedback and makes necessary changes to correct or improve situations.

• Ability to work with excel spreadsheets.

• Preferred:

CRM