Coding Reimbursement Specialist II

3 days ago

Charlotte, North Carolina, United States Tryon Medical Partners Full time $60,000 - $90,000 per year

Job Summary:
The Coding Reimbursement Specialist II performs various duties to accurately interpret and bill physician charges for physician services by entering into the appropriate CPT, ICD-10, and modifiers into the Billing system.

(This is a full-time position with remote eligibility, Monday to Friday 8 am to 5 pm)
Primary Job Responsibilities/Tasks may include, but not limited to:

  • Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers
  • Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services, according to guidelines established by the AMA
  • Enter appropriate data into the TMP billing system by selecting the appropriate codes, diagnosis, modifiers, to complete the charge process
  • Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met
  • Contacts physicians through query protocols regarding procedures and other services billed to ensure proper coding
  • Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients
  • Reviews all physician documentation to ensure compliance with third party and regulatory guidelines
  • Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for TMP physicians' services
  • Performs other related duties as required and assigned

Requirements:
Education and Certifications:

  • High school diploma or GED completion is required
  • A minimum of three (3) years' experience with CPT and ICD-10 coding of physician services required
  • Coding certification required. CPC Certification preferred. Must maintain active certification and required CEUs during employment tenure.
  • Advanced working knowledge of medical terminology, anatomy, and physiology required
  • Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers.
  • Understanding of and familiarity with regulatory guidelines including NCDs and LCDs

Experience:

  • Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, and Dermatology preferred
  • Knowledge of current third-party billing and collection regulatory guidelines and requirements
  • Advanced knowledge of the ICD-10 CM/PCS and CPT/HCPCS coding systems and conventions
  • Advanced knowledge of, but not limited to, Official Coding Guidelines and methodologies
  • Knowledge of current third-party billing and collection regulatory guidelines and requirements
  • Good interpersonal skills and a basic understanding of team concept
  • Ability to gather and interpret clinical data
  • Ability to work independently in a fast-paced environment

Physical Requirements:

  • Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling
  • Must be able to lift and support weight of 35 pounds.
  • Ability to concentrate on details
  • Use of computer for long periods of time

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