Certified Coding Specialist
68221 - Business Office NCHHG
High school diploma or GED required
The Coding Specialist is responsible for all aspects of medical coding for physician services. This includes office, outpatient, hospital – both inpatient and outpatient, and ancillary services. The Coding Specialist will understand ICD-9, ICD-10, CPT and HCPCS coding; have the ability to interpret insurance guidelines relative to medical coding; understand daily balancing techniques; understand abbreviations and medical terminology; have the ability to read a medical chart; and be able to understand the basic components of medical and ancillary procedures. This position will have responsibility for reviewing medical records for inpatient and outpatient visits and procedures and code them appropriately and accurately. This position will have responsibility for educating physicians, healthcare providers, and office staff in correct coding in order to improve accuracy. Position will identify opportunities for improvement and bring issues to the attention of the supervisor. The position may also include duties such as data entry, claims filing, review of remittance advices, patient account inquiries, and research on billing/coding issues. Above all, this position serves to exceed the expectations of patients and all other customers we serve. The Coding Specialist will work as a team member with Billing Specialists and Patient Service Representatives to assure data entry is accurate and complete. At all times this Associate will conduct their work efforts with the ultimate goal of providing high quality, efficient service for the patients and payors of NCH Physician Group.
ESSENTIAL DUTIES AND RESPONSIBILITIES – Other duties may be assigned.
Understands daily balancing techniques in the electronic practice management system, and is able to review patient accounts in order to answer staff and customer questions.
Facilitates preparation and processing of daily charge documents including office and hospital charges.
Performs review of edit reports in order to make necessary corrections and refile charges promptly and accurately.
Provides education to Physicians and healthcare staff regarding correct coding rules and procedures, advising in proper code selection, required documentation, and other requirements. Ensures appropriate and efficient outpatient and inpatient professional coding.
Reviews records as assigned and reports results to supervisor.
Documents all conversations and actions in the computer under the "notes" section of the patient's account.
Reviews insurance Explanation of Benefits and all billing correspondence for denials, trends, and payment errors making necessary corrections to insure payment.
Stays current on all CPT and ICD-9/ICD-10 changes and issues, and insurance/ contractual updates that effect reimbursement. Attends 95% of Physician Group billing meetings and 1 to 2 outside billing seminars per year.
Associate may have duties that include data entry, claims filing, review of patient accounts, and have responsibility to research billing/coding issues.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
Minimum of High School or GED required
Associate Degree preferred
Coding experience preferred, Medical billing experience preferred
Must be a Certified Professional Coder (CPC), through an accredited national organization such as the American Academy of Professional Coders (AAPC)