Position Overview: Reporting to the Coding Manager, the Coding Specialist is responsible for assigning medical codes to facility charges for multispecialty outpatient surgical facilities resulting in claims reimbursement.
Responsibilities:
- Review and analyze medical records to identify diagnoses, procedures, and services provided
- Assign appropriate ICD-10 codes to reflect the diagnoses and procedures documented in the medical records.
- Ensure coding accuracy and compliance with coding guidelines, regulations, and payer requirements.
- Manage daily coding email queues providing responses within 3 business days.
- Problem-solve claim edits and support the denial process as requested.
- Uphold productivity standards / goals set by coding leaders
- Maintain coding quality accuracy rate of 95.5%
- Identify documentation issues (lacking documentation) that impact coding accuracy.
- Clearly communicate (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.
- Must possess knowledge of third-party reimbursement regulations and billing practices
- Ability to examine documents for accuracy and completeness
- Ability to understand and follow compliance issues of moderate complexity by utilizing appropriate coding/compliance resources
- Must possess moderate knowledge of CCI edits and LCDs and be able to accurately apply regulation knowledge to coding situations
· Additional duties as assigned.
Required Skills
- RHIA, RHIT, CPC, COC, or CCS certification required.
- Associates degree in relevant field preferred or combination of equivalent of education and experience
- Must have knowledge of AMA, CMS, and CPT coding guidelines.
- Knowledge of ICD-10-CM, medical terminology, anatomy & physiology.
- 2+ years of ASC revenue cycle or coding experience.
- Proficient in Microsoft Word, Excel
- Ability to maintain required productivity and accuracy standards.
- Excellent verbal and written communication skills.
- Ability to prioritize workload, handle competing priorities, while meeting or exceeding deadlines.
Required Experience