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Medical Coding Specialist

1 month ago

Dallas, Texas, United States United Surgical Partners Full time
Job Summary:

As a Medical Coding Specialist at United Surgical Partners, you will play a critical role in ensuring accurate and timely reimbursement for our patients. This position requires a strong understanding of reimbursement and coding knowledge to resolve outstanding medical claims that are pended or denied for various coding reasons specific to government and commercial payers.

Key Responsibilities:

• Manage daily coding email queues, providing responses within 3 business days.

• Investigate and resolve coding-related denials from payers, resulting in claim reimbursement.

• Identify documentation and coding guidelines or regulations to defend the claim as billed or support the payer's denial for corrections needed.

• Formulate reportable data into trends that can be utilized to develop process improvements, including tracking of all coding queries, denials, and reimbursement outcomes.

• Analyze all aspects of patient medical records to locate documentation to support medical necessity.

Requirements:

• RHIA, RHIT, CPC, or CCS certification required.

• Knowledge of AMA, CMS, and CPT coding guidelines.

• Knowledge of ICD-10-CM, medical terminology, anatomy & physiology.

• 2+ years of ASC revenue cycle or coding experience.

• High School diploma or equivalent.

• Ability to maintain required productivity and accuracy standards.

• Excellent verbal and written communication skills.

• Ability to prioritize workload, handle competing priorities, while meeting or exceeding deadlines.