Certified Coding Specialist I - Remote

Certified Coding Specialist I - Remote

POSITION DESCRIPTION :

Reviews evaluation and management codes, modifiers, procedures, injections and diagnosis codes entered by physicians to ensure correct coding was entered by the physician. Facilitates appropriate billing for inpatient, outpatient, ER and special procedures, such as, but not limited to, OB deliveries, by reviewing the physician’s documentation to substantiate the level of coding. Physician services include identification of professional services in, and complete review of, medical records to accurately optimize all professional services documented for billing.

ESSENTIAL JOB FUNCTIONS :

The following job functions may not be the responsibility of all Certified Coding Specialist I’s. Some Certified Coding Specialist I’s will be assigned work that has more focused responsibilities.

• Review’s warnings / errors in EPIC that are triggered when inappropriate code or modifier combinations are used.
• Maintains complete knowledge and complies with all relevant insurance, CPT coding and diagnosis guidelines, disseminating information to staff and providers as necessary.
• Verifies provider chosen codes for non-invasive procedures.
• Runs daily reconciliation reports to ensure all charges are captured for each H&P, consult and discharge summary note entered into EPIC by physicians.
• Maintains query communication with providers to ensure timely notification of identified documentation issues that may impact revenue or compliance.
• Attends meetings with physicians and other clinical staff as required. Attends other regularly scheduled meetings.
• Creates relationships with external organizations that allow for streamlining and quick resolution of billing matters for patients.
• Coordinates and follows through with special projects as assigned.
• Performs other duties as assigned.

ORGANIZATIONAL EXPECTATIONS :

MEASURED BY :

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS :

EDUCATION : High School Diploma or GED.

CREDENTIALS / LICENSURE : One of the following certifications is required : AAPC (CPC, CPC-A), PMIC (CMC), AHIMA (CCS-P).

MINIMUM EXPERIENCE : 2 years’ experience in a healthcare setting.

POSITION REQUIREMENTS (ABILITIES & SKILLS) :

MINIMUM PHYSICAL EXPECTATIONS :

MINIMUM ENVIRONMENTAL EXPECTATIONS :

This job is mainly remote, there will be times you will be expected to come into the office and adequate notification will be given.

When working in-office, the job operates in a typical office environment which involves frequent interruptions and significant interaction with people, which can be stressful at times.

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