Coding Specialist

JOB TITLE

Coding Specialist

REPORTS TO

Revenue Cycle Manager

FLSA STATUS

Non-Exempt

JOB SUMMARY

In-depth knowledge of Procedural Coding, Specialist in identifying appropriate ICD10 coding based on CMS/HCC categories, analyzes medical records and identifies documentation deficiencies, CPT, HCPCS

CMS 1500

FORM, Super Bill, Electronic Claims Submission and Clearing House Operations, EOB, Payments.

QUALIFICATIONS/EDUCATION

High School Diploma or higher education required Minimum 2 years of experience in medical billing and procedural coding Bi-lingual English/Spanish preferred; must be able to read, write and speak English. Basic computer knowledge; MS Word and MS Excel, internet, document with Electronic Health Records and/or authorization system with minimal typing/spelling errors, send e-faxes and email

CERTIFICATIONS/LICENSES

CPC Preferred

ABILITIES/SKILLS

In depth knowledge of CPT, ICD10 and HCPCS coding. Excellent communication, Customer Service and telephone skills. Strong organizational skills and ability to multi-task effectively. Must be able to work independently with minimal supervision. Able to respect and maintain patient confidentiality at all times. Functions with minimal direct supervision. Must be dependable and conduct him/herself in a professional manner. Demonstrates skill in use of personal computers, various programs and applications required to competently execute job duties. Must be able to follow policies and procedures.

SUPERVISORY RESPONSIBILITIES

N/A

ESSENTIAL DUTIES/ RESPONSIBILITIES

Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes coding data to maximize reimbursement. Process claims daily, check for errors, making sure that correct diagnosis and CPT codes are used. Review claims and determine if Auth or Referral is needed, process accordingly. Maintain the billing process within a 15 - day timeframe. Must be able to process between 80 to 100 claims per day and submit batch to clearinghouse daily. Review progress notes and operative reports before submitting claim. Review patient information to determine or identify claim denial causes. Submit weekly billing report to manager. Maintain accurate and detailed chart notes in the system. Perform any other duties as assigned.