Medical Coding Specialist
3 weeks ago
The role of a Medical Coding Specialist at HealthyU Clinics involves ensuring accurate and compliant coding of diagnoses, procedures, and medical services provided. This requires a thorough understanding of ICD-10, CPT, and HCPCS coding systems, as well as a commitment to maintaining confidentiality, accuracy, and efficiency in coding processes.
This position requires collaboration with healthcare providers, billing teams, and management to optimize reimbursement and reduce claim denials.
Key Responsibilities:
- Medical Coding and Billing: Review and assign appropriate codes to diagnoses, procedures, and services provided to ensure accurate and timely billing.
- Compliance: Ensure all coding practices comply with federal and state regulations, including HIPAA, as well as insurance company guidelines.
- Audits and Quality Assurance: Conduct internal coding audits to verify coding accuracy, identify trends in coding discrepancies, and report findings to the Billing Manager.
- Collaboration with Providers: Work with physicians, nurse practitioners, and other providers to clarify diagnosis and procedures for accurate coding.
- Documentation Review: Regularly review clinical documentation to ensure it meets the necessary requirements for coding and billing and provide feedback or training to improve documentation quality when needed.
- Denial Management: Investigate coding-related claim denials, initiate corrections, and resubmit claims as required to maximize revenue capture.
- Continuous Education: Stay current on coding changes, healthcare regulations, and insurance policies, and participate in ongoing training as required by HealthyU and CPC certification standards.
Requirements:
- Certification: Must hold a current Certified Professional Coder (CPC) certification
- Education: High school diploma or equivalent required; associate degree in health information management or related field preferred.
- Experience: Minimum of 2 years of coding experience in a healthcare setting, preferably in primary care or specialty clinics.
- Technical Skills: Proficiency in electronic health record (EHR) systems and coding software.
- Knowledge Base: Strong understanding of medical terminology, anatomy, physiology, and coding principles, including ICD-10, CPT, and HCPCS.
- Communication Skills: Excellent written and verbal communication skills, with the ability to collaborate with healthcare providers and team members.
- Attention to Detail: High degree of accuracy and attention to detail in all aspects of coding and billing processes.
- Problem-Solving: Ability to analyze, research, and resolve coding and billing discrepancies effectively.
Working Conditions:
This position may involve both on-site and remote work, depending on departmental needs. Standard office environment with occasional extended hours as needed.
Salary: $24-26 per hour
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