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Coding Specialist, Gastroenterology, Full-Time, Days
1 month ago
Job Description
Make sure to apply with all the requested information, as laid out in the job overview below.
The Coding Specialist I reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
The Coding Specialist performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 9 (ICD9) coding through abstraction of the medical record. This position trains physicians and other staff regarding documentation, billing and coding, and performs various administrative and clerical duties to support the role’s core function.
The Coding Specialist – Gastroenterology, abstracts and codes hospital GI services (inpatient/outpatient procedures, diagnostic services and outpatient clinic encounters). This role is responsible for assigning appropriate CPT codes to all encounters and ensuring all hospital charges are captured (ie. supplies, recovery time, anesthesia minutes, etc). Additionally, they audit/reconcile accounts to ensure complete and accurate coding/charging. The Coding Specialist works collaboratively with physicians and staff in the ambulatory clinic and endoscopy lab. They communicate directly to physicians regarding documentation issues identified during account review. They also serve as a key point of contact for patient billing questions/complaints and assist with coordinating appropriate responses to patients. The Coding Specialist is responsible for identifying gaps and opportunities for improvements in workflows, documentation, coding, billing and pricing. Additionally, they collaborate with physicians, leadership and staff on initiatives with coding/billing implications (ie. new service offerings). This role reports through Digestive Health Center operational leadership.
Responsibilities:
*Abstracts and codes physician professional services and diagnosis codes (inpatient admissions, outpatient procedures, diagnostic services).
* Assigns appropriate CPT and ICD9 codes.
* Completes coding and billing worksheet.
* Ensures charges are captured by performing various reconciliations (procedure schedules, clinical system reports, fatal edit reports).
* Provides documentation feedback to physicians.
* Maintains coding reference information.
* Trains physicians and other staff regarding documentation, billing and coding.
* Reviews and communicates new or revised billing and coding guidelines and information.
* Attends meetings and roundtable, communicates pertinent information to physicians and staff.
* Resolves pre-accounts receivable edits, monitors reasons for missed billing opportunities, maintains non-compliance logs, identifies repetitive problems, works with physicians to resolve.
* Deletes incorrectly billed services, adds missing unbilled services, provides missing data as appropriate, corrects CPT and ICD9 codes and modifiers.
* Drafts letters and coordinates appeals.
* Works with Revenue Cycle staff and Account Inquiry Unit staff as requested, assists in obtaining documentation (operative reports, etc.).
* Provides invoice disposition instruction.
* Provides additional code and modifier information.
* May perform other duties as assigned.
