Coding Specialist II - Medical Coding & Compliance Expert

Description

In this role, you will be essential in ensuring accurate and complete coding of medical services. Your extensive knowledge of regulatory and payer requirements will help recommend policy and procedural changes to enhance reimbursement for services provided. Collaboration with physicians on coding issues is critical, as is ensuring compliance and accuracy in encounter forms, billing systems, and processes. Support for the manager and mentorship for Coding Edit Specialists and Coding Specialists I will also be part of your responsibilities.

Primary Responsibilities

• Abstract and ensure the accuracy of diagnosis, procedure, patient demographics, and other required data elements.
• Utilize coding software for verification and synchronization of technical and professional component coding on accounts.
• Assist in creating training and educational coding guidance for physicians and associates, while updating billing, coding, and edit dictionaries in the billing system.
• Communicate with physicians regarding conflicting or ambiguous information in medical records and request missing diagnoses.
• Determine the correct sequence of diagnoses for accurate claims submission.
• Utilize coding compliance knowledge to meet quality standards identified through coding reviews.
• Provide mentoring and guidance on projects for Coding Specialists I and Coding Edit Specialists, including reviewing and correcting code selection.
• Identify and report issues and trends in physician documentation and coding from other departments.
  
  

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• CPC (Certified Professional Coder) certification required.
• 3-4 years of medical-professional coding experience with the ability to work independently.
• 1-2 years of experience leading others or managing work streams.
• Proficiency in computer systems for encoding and abstracting.
• Exceptional attention to detail and strong organizational skills.
• Effective communication skills for professional interaction with physicians, liaisons, and associates.
• Ability to articulate and understand medical terminology related to various body systems.
• In-depth knowledge of the billing process, including claims submission, payer requirements, modifiers, and correct diagnosis/procedure linkage.
• Broad medical knowledge, including terminology, human anatomy, and procedures.
• Working knowledge of payer policies, HCFA policies, and regulatory standards.
  
  

Remote Work Options Available

Compensation

This position has a hiring range of \(28.20 - \)44.83 per hour.

Employment Type: Full-Time