Coding and Documentation Review Specialist

Catholic Health; Melville (NY); On-site; USD 65,000 - 80,000; Full time

Benefits offered by this job

Generous benefits

Tuition assistance

Defined pension plan

Career growth opportunities

Job summary

Requirements include a high school diploma and coding certifications (CPC, RHIT, CCS); familiarity with EHR systems and strong communication skills are essential. Competitive salary with robust benefits and growth opportunities.

Qualifications

• Must be able to interact with physicians, nurses and team members.
• Experience with medical coding and billing fundamentals.
• Familiarity with CPT/ICD-10 guidelines for inpatient and outpatient care.

Responsibilities

• Review provider documentation and coding for inpatient and outpatient services before charges are released.
• Query items needing review or correction related to coding.
• Monitor regulatory changes affecting billing and coding.
• Serve as a resource for data mining and coding to ensure reimbursement accuracy.
• Identify coding issues related to denials and assist with training materials.
• Accurately code CPT and diagnoses; maintain productivity and accuracy.

Skills

Physician interaction

Team oriented

Research skills

Independent worker

Medical terminology

ICD-10 proficiency

CPT proficiency

Detail oriented

Strong communication

Education

High School diploma

CPC certification

RHIT

CCS

Tools

MS Word

MS Excel

EHR systems

Job description

Overview

Catholic Health is one of Long Island’s finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island.

At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes – to every patient, every time.

We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace!

Job Details

Responsible for the review of provider documentation and coding charge review errors as well as Evaluation and Management coding. Ensure that the coding is appropriate before releasing the claims to be billed. Identify trends and opportunities for improved documentation and billing and communicate those trends with the Coding Educators and providers. Must be fluent with the Evaluation and Management / CPT coding guidelines, ICD10 coding guidelines for outpatient, inpatient, observation coding including but not limited to all office-based services, procedural coding and hospital rounding.

Duties/Responsibilities

• Review documentation and coding for both inpatient and outpatient (hospital and office) professional services before the release of charges.
• Queries the provider of items in the chart that need to be reviewed or corrected as it relates to the coding selected.
• Responsible for monitoring regulatory changes as they apply to billing and coding in the inpatient and outpatient setting.
• Serves as resource to the practices/departments for data mining and coding to ensure reimbursement accuracy.
• Identifies coding issues related to billing denials, collaborates with the Coding Educator and Revenue Integrity as needed to assist with the preparation of training materials and examples to prevent future coding/billing issues.
• Accurately code CPT and diagnoses.
• Expected to maintain department productivity standards and accuracy rates.

POSITION REQUIREMENTS AND QUALIFICATIONS

• High School diploma required
• Coding certification(s): CPC, RHIT, CCS

Skills

• Must be able to interact in a positive manner with physicians, nurses and other team care members
• Demonstrates personal initiative, team spirit, and service orientation while maintaining a positive, caring, professional attitude
• Excellent research skills as it relates to medical specialties, documentation and coding requirements.
• Dependable, motivated, professional and work well independently or with a group.
• Medical terminology, ICD10 proficiency, CPT proficiency
• Highly organized and pays close attention to detail.
• Strong written and verbal abilities.

Experience

• Minimum of 1 year coding experience
• 1-2 years practice operations/revenue cycle experience.
• Knowledgeable in electronic health record systems
• Microsoft Word and Excel

Salary Range

USD $65,000.00 - USD $80,000.00 /Yr.

This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.

At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.