Senior Coding Specialist

2 days ago


New York, New York, United States Houston Methodist Full time
About the Role

Houston Methodist is seeking a highly skilled Senior Coding Specialist to join our team. As a Senior Coding Specialist, you will be responsible for applying correct coding conventions to patient charge encounters in a clinical environment.

Key Responsibilities
  • Communicate with physicians and Physician Organization Central Business Office (PO CBO) staff on clarification to accurately code diagnosis and procedures.
  • Collaborate with management on coding and diagnosis issues to reduce claims denials by providing verbal and written communication.
  • Assist with knowledge sharing, training Coding Specialists, and department cross training; provide support to other team members as advised by the manager and/or supervisor.
  • Respond to or clarify internal requests from all business partners for medical coding information in a timely manner.
  • Participate in coding round tables and in-services for continuing education.
  • Cross train and provide back up coverage of team members to ensure continuous coding and charge capture activities for PO departments.
  • Code and abstract medical records for reimbursement purposes from patient charts, physician documentation, and medical diagnostic and/or interventional reports using current coding conventions and guidelines and tools such as 3M encoder.
  • Review individual medical records to verify and substantiate diagnosis and procedures for charge review, claim edit(s) and/or denied claims and submits clinical appeal or corrected claim.
  • Match charge documents to charge review & claim edit sessions, billing sheets, operative reports, and medical records to ensure correct codes are applied and billable services are captured.
  • Work charge review and claim edit sessions within two business days of posting to the assigned work queues.
  • Investigate and appeals unpaid, denied and partially paid claims by third party payors.
Requirements
  • High School diploma or equivalent education.
  • Five years of professional coding experience.
  • CPC - Certified Professional Coder (AAPC) or CCS - Certified Coding Specialist (AHIMA) or an approved Specialty Society Coding Certification.


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