Medical Coding Specialist

3 weeks ago

Naples, United States NCH Healthcare System Full time
DEPARTMENT: 68221 - Business Office NCHHGLOCATION: 1100 Immokalee Road, Naples, FL, 34110WORK TYPE: Full TimeWORK SCHEDULE: 8 Hour Day

Eastern Standard Time Only

ABOUT NCH

NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.

NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.

Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH - for you and every person we serve together. Visit nchjobs.org to learn more.

JOB SUMMARY

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.

· Reviews medical records in order to code visits and procedures to highest specificity and accuracy according to NCH Physician Group’s policies.

· 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

· Must be a Certified Professional Coder (CPC), through the American Academy of Professional Coders (AAPC).

· Minimum of High School or GED required.

· Associate Degree preferred.

· Coding experience preferred, Medical billing experience preferred.

· Must have basic accounting knowledge and skills.

· Must have excellent communication skills- both verbal and written.

· Computer experience with PC environment-preferred.

· Knowledge of CPT and ICD-10 codes – evidence of updated education.

· Knowledge of medical terminology.

· Proven self-starter with ability to motivate personnel.

· Knowledge of insurance industry and billing procedures preferred.

· Intermediate computer knowledge: Uses Microsoft Word, Excel, Outlook, and Windows.

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