Medical Coding Specialist

5 days ago


Linthicum Heights, Maryland, United States CoreLife Full time

We are seeking a Medical Coding Specialist to contribute to our team's success. This role involves reviewing, approving, and translating medical documentation into accurate codes to ensure patient billing aligns with services provided at CoreLife's medical practices.

About the Role

This position will involve coding based on provider documentation, contributing to reports for quality assessment, audits, and billing purposes. The candidate will also support providers in educating them on proper coding and documentation practices as needed.

Key Responsibilities:
  • Coding and Compliance: Review office notes and other documentation to assign appropriate diagnoses (ICD-10), procedure codes (CPT), and other necessary coding items (HCPCS) for final billing.
  • Invoice Corrections: Research and process invoice corrections related to coding discrepancies.
  • Coding/Billing Procedures: Analyze and review coding/billing procedures.
  • Training and Feedback: Provide training and feedback to physicians and providers regarding medical coding, compliance, and reimbursement.
  • Trend Analysis: Report trends and coordinate reimbursement improvement activities with management.
  • Payer Policy Documentation: Create and maintain payer policy documentation as required.
  • Chart Audits: Perform chart audits to ensure accuracy and compliance with coding standards.
  • Confidentiality: Maintain confidentiality of all client, patient, caregiver, and team member information in accordance with HIPAA regulations.
Requirements and Qualifications

To be successful in this role, you will need:

  • Education: High School Diploma or GED.
  • Experience: Minimum of 1 year as a certified coder.
  • Certification: CPC (Certified Professional Coder) or similar certification is required.
  • Knowledge:
    • Familiarity with E/M coding is required; experience with Obesity management and nutritional management coding is a plus.
    • Strong knowledge of Medicare, Commercial, and Medicaid Risk Adjustment programs.
    • In-depth knowledge of Quality Concepts such as HEDIS, Medication Adherence, CAHPS, and HOS.
    • Ability to navigate member benefits across multiple product lines (Commercial, Medicaid, and Medicare Advantage).
    • Knowledge of medical terminology, provider reimbursement payer policies, ICD-10, HCPCS, and CPT-4 coding.
What We Offer

As a CoreLife teammate, you can expect:

  • A competitive salary based on experience ($20 - $23 an hour)
  • Medical, dental, and vision insurance
  • Wide selection of ancillary benefits
  • Paid time off
  • 7 paid holidays
  • Retirement plan

CoreLife is an Equal Opportunity Employer.



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