SpineOne Certified Professional Coder Job Description

Qualifications:

• High School Diploma/GED.
• CPC-Certified Professional Coder Certification through the AAPC-American Academy of Professional Coders.
• Minimum of 2 years of relevant experience in medical coding, with a focus on Pain Management and Radiology.
• Excellent communication, customer service, and training skills.
• In-depth knowledge of CPT, HCPCS codes and ICD-10 codes used for billing Pain Management, Anesthesia, and Radiology claims.
• Knowledge and understanding of insurance benefit plans, payer rules, and explanation of benefits.
• Current knowledge of regulatory requirements with payer mixes such as CMS and Medicaid.
• Excellent interpersonal skills to work collaboratively with clinical and administrative staff.
• Critical and analytical thinking, organization, and problem-solving skills.
• Ability to utilize various software applications and information systems to perform work processes.
• The ability to ability to adapt to changes in the healthcare industry and remain up to date on relevant regulations and guidelines.

Responsibilities:

• Monday - Friday hybrid 8-hour shift during normal business hours
• Dynamic Full Revenue Cycle Management Team that specializes in billing, collections, identifying patient reimbursement issues, ensuring that claims, denials, and appeals are efficiently processed, and resolving billing-related issues.
• 100% Abstracting from the providers documentation.
  • You should also be able to code diagnoses and procedures correctly.
• Perform Evaluation and Management (E&M) coding and review and audit Pain Management, Anesthesia, and Radiology claims.
• Perform Pain Management, Anesthesia, and Radiology coding.
• Assign and sequence codes for diagnosis, procedures, professional services, facility services and other services as needed utilizing the applicable coding conventions per regulatory requirements.
• Work in collaboration with the Revenue Cycle Team, Operations, and Finance.
• Conduct audits of medical records to ensure documentation supports the assigned codes.
• Work collaboratively with clinical and administrative staff to resolve any coding or billing issues.
• Conduct periodic and ongoing coding training for the clinical team.
• Stay current with changes to CPT, HCPCS codes and other billing regulations related to medical coding and billing.
• Respond to any and all staff coding questions and inquiries.
• Serve as SpineOne resident SME-Subject Matter Expert on Coding.
• Ensure compliance with all applicable laws and regulations related to medical coding and billing.
• Collaborate with the Revenue Cycle Team on any and all new or changes to the billing practices and protocols.
• Utilize available coding software and other coding resources to determine the appropriate ICD-10, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes and modifiers.
• Maintain timely coding productivity and 95% quality standards.
• Maintain and comply with HIPAA policies and procedures for confidentiality of all patients’ medical records.

Benefits:

• Salary Range: $21.00 - $30.00 Hourly
• We have a hybrid work schedule where you can enjoy working remotely and work one day in the office per week.
• Starting wage is based on experience.
• Paid twice a month.
• Dental, vision, and health insurance offered.
• 401K retirement plan.
• Life Insurance at no cost.
• Generous Paid Time Off.