ProBill

Medical Coding Specialist

POSITION SUMMARY

Understand clinical content of a health record and assign appropriate ICD-9, ICD-10, HCPCS, and CPT codes in accordance with official guidelines and Bettinger/Stimler methodologies.

DUTIES/RESPONSIBILITIES

1. Translate physician services into the appropriate CPT, ICD-9, and ICD-10 codes.
2. Enter codes into the billing system for claim and statement distribution.
3. Identify and flag chart deficiencies within the billing system.
4. Process and follow up on coding denials and update incorrect claims.
5. Perform chart reviews and audits for new business development.
6. Maintain quality and production standards as set forth by company guidelines.
7. Maintain records of daily production.
8. Maintain CEU’s and education required for AHIMA and/or AAPC certification.
9. Maintain confidentiality and adhere to HIPAA regulations.
10. Perform daily tasks with frequent interruptions and change in work priorities, as necessary.
11. Must be able to function in an independent, collaborative, and shared leadership environment.
12. Required to learn other job functions to assist other departments with their goals.

MENTAL/PHYSICAL DEMANDS

1. Ability to analyze and interpret data with minimal supervision.
2. Ability to work independently and prioritize work load with little or no supervision in a fast paced environment.
3. Ability to collaborate and interact with various departments.
4. Ability to articulate and educate physicians on best documentation practices.
5. Ability to sit for prolonged periods of time to perform repetitious tasks.

EXPERIENCE/REQUIREMENTS

1. Certified CPC and/or ED Coding and ICD-10 Certification.
2. Two years’ experience with outpatient coding.
3. One year experience in another aspect of medical billing.
4. Comprehensive knowledge of medical terminology, anatomy, and physiology, and diagnostic and procedural coding (CPT, ICD-9, ICD-10, and HCPCS).
5. Computer experience utilizing various systems, applications, and websites, i.e. GE, Centricity, Microsoft Work, Excel, Adobe, super coder, etc.
6. Ability to access and recognize appropriate electronic documents and medical record contents necessary for coding.
7. Analyze and resolve claim edits, denials, and assist with appeals process.
8. Effectively communicate coding methodologies and documentations best practices with coworkers, clients, patients and insurance carriers.
9. Knowledge of Medicare, Medicaid and State regulations.
10. Some travel may be required.