Medical Coding Specialist II
1 week ago
Position Overview:
Efficiently and accurately reviews a diverse range of specialty physician billing and Health Information Systems to gather and secure all necessary documentation for precise coding and billing of professional physician and/or mid-level services.
Key Responsibilities:
- Analyzes medical records and applies coding for physician services using the latest ICD-10, CPT, and HCPCS classification systems.
- Assigns codes for diagnoses, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and medications in accordance with International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT), and Health Care Financing Administration Common Procedure Coding Systems (HCPCS).
- Confirms billable physician services by evaluating physician documentation to ensure compliance with established federal guidelines.
- Reports any discrepancies or trends identified in the documentation of healthcare providers to their Senior Coder for further assessment and follow-up.
- Collaborates with specialty team members to consistently track financial objectives within their specialty to meet corporate targets.
- Assists the Central Business Office in ensuring thorough follow-up on patient accounts to optimize reimbursement, including addressing insurance denials.
- Engages in effective communication with physicians, physician extenders, physician offices, coding team members, and management.
- Utilizes available departmental resources to support accurate coding practices.
- Upholds patient confidentiality at all times.
- Demonstrates strong verbal and written communication skills.
- Maintains a coding accuracy rate of 90% or higher.
- Participates in departmental meetings and other scheduled gatherings.
- Adheres to regular attendance policies consistent with organizational standards.
- Ensures compliance with all organizational policies and procedures.
Education/Training
- High school diploma or equivalent required.
- Proficient in computer skills, typing, and possesses knowledge of Anatomy, Physiology, and Medical terminology.
- Comprehensive understanding of CPT and ICD coding, demonstrated by achieving a coding skills test score of 80% or higher.
Licensure/Certification
One of the following national certifications is required:
- Certified Professional Coder (CPC) from the American Academy of Professional Coders.
- Certified Coding Specialist (CCS) from the American Health Information Management Association (AHIMA).
- Certified Coding Specialist-Physician (CCS-P) from AHIMA.
- Certified Coding Associate (CCA) from AHIMA.
- Certified Medical Coder (CMC) from Practice Management Institute.
Experience
- Minimum of three (3) years of certified coding experience in professional or physician practice coding.
- Preferred proficiency in multi-specialty E/M coding and minor bedside procedure coding.
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