- PRIMARY FUNCTION
- The Coding Specialist is responsible for reviewing and applying applicable diagnosis, procedure codes, and modifiers as needed, in adherence with departmental policies for services provided by physicians and allied health providers.
- ESSENTIAL FUNCTIONS OF THE JOB
- This list may not include all of the duties that may be assigned.
- Support the collections department to maintain the expected level of quality from a coding perspective. This includes reporting trends and recommendations for potential quality enhancements.
- Performs coding audits as designed to maintain the integrity of the billing practice.
- Communicates areas of improvement from a provider documentation standpoint and creates formal recommendations.
- Meet and maintain all department and personal production goals as directed by the Manager.
- Correction of daily coding errors/denials.
- Participates in the ongoing review process, as directed by the Manager to assure the accurate application of CPT, ICD-10, and/or HCPC’s codes, the capture of all services provided, and that services which were not performed are not billed for.
- Accurate coding of CPT, ICD-10 and Physician assignment of all medical records
- Maintains continuing educational criteria for ongoing certification. Certification is the responsibility of the individual coder and verification of certification(s) or credentialing must be possible.
- Comply with all company policies and procedures
- Other duties as assigned
- PERFORMANCE REQUIREMENTS
- High school diploma or equivalent
- CPC, CPC-H, CCS, CCS-P, or RHIT Certificates will be considered
Knowledge, Skills & Abilities:
- Knowledge of billing and coding policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.) Skilled in defining problems, collection of data, interpreting billing information and provider documentation Ability to communicate effectively and clearly.
- Three years of coding experience in a medical environment preferred.