Coder II- Days

Coder II- Days

Job ID: P Tupelo Administrative Support - CODING REIMBURSEMENT Full Time - Day

Posting Description

At North Mississippi Health Services, our mission is to continuously improve the health of the people of our region. Our vision is to provide the best patient and family-centered care and health services in America. We believe that fulfilling our mission and vision calls us to embrace the best people that form incredible connections to our patients and families.
We take pride in celebrating everything that makes you uniquely you your talents, your perspectives, and your passions. At North Mississippi Health Services, we believe in connecting your passion with a purpose. When you are part of our team, you know what connected feels like.
#WhatConnectsYou
#NMHSConnections

Job Description

Coding: Assign diagnostic and procedural codes using ICD-10-CM and CPT coding systems for inpatient, outpatient, and ambulatory surgery records in order to ensure accurate billing and statistical information by reviewing provider documentation. Apply coding knowledge of ICD-10-CM and CPT to denial review to ensure accurate coding, compliance and reimbursement. Research and apply coding/billing guidelines for various carriers. Knowledge of Hierarchical Condition Category coding to ensure accurate diagnosis coding and future reimbursement.
Reimbursement: Apply local Medical Review Policies regarding medical necessity to all insurance carriers procedures to ensure appropriate reimbursement for the provided service. Follow up with insurance carriers on outstanding appeals and/or incorrect allowable/reimbursement. Identify reimbursement opportunities through documentation review and denials for NMMCI and MSO=s.
Denials: Research causes for insurance denials by reviewing provider documentation, medical policy, and coding guidelines. Determine if the documentation is compliant with guidelines and supports all services billed. Decide if the denial can be sent for appeal, the provider be held accountable, or if patient is responsible. Corrections are made to the patient=s account and with insurance carrier as needed.
Compliance: To abide by NMHS Coding Compliance Policy, ICD-10-CM and CPT Coding Guidelines and Standards of Ethical Coding. Determine if provider=s documentation meets coding guidelines and involve the Coding Specialist to provide education as needed. .
Customer Service: Effectively interacts and assist NMMCI and MSO clinic managers, charge entry personnel, and physicians with determining appropriate CPT codes for their charges, coding guidelines, medical policies and education to gain trust, commitments, and a strong work relationship.
Job Knowledge: Certified Coding Specialist (CCS), RHIT (Associate Degree) or Certified Professional Coder (CPC) required within 6 months of hire. One year previous outpatient coding experience with and CPT coding schemes including evaluation and management codes and experience with insurance carriers, preferred. Thorough knowledge of medical terminology, previously completed course in basic anatomy and the ability to read and interpret medical record documentation. Ability to operate PC.

Requirements

The following are requirements in addition to any stated in the above description.

Education

You must have the following education to apply:

Associates of Health Information Management

You must have a Associates or higher

---