Coding Reimbursement Specialist- Clinic

Shannon Medical Center; San Angelo (TX); In loco; USD 60.000 - 85.000; Tempo pieno

Descrizione del lavoro

Shannon Medical Center is seeking a Physician Coding Specialist to assign ICD-10-CM, CPT, and HCPCS codes based on patient records. You will open help tickets, query physicians, and ensure accurate charge capture within the Epic ecosystem.

Responsibilities include identifying principal diagnoses and procedures, auditing Locum Tenens and Level 5 services, maintaining productivity, and staying current with payer coding requirements and reimbursement changes.

Competenze

• Identify principal diagnoses and procedures using ICD-10-CM, CPT, HCPCS with appropriate modifiers.
• Audit Locum Tenens charges and Level 5 services for accuracy and compliance.
• Maintain knowledge of coding and reimbursement changes; regular training participation.

Mansioni

• Identify principal diagnoses and procedures on patient records and code using ICD-10-CM, CPT, HCPCS.
• Audit Locum Tenens charges and Level 5 services; open help tickets as needed.
• Maintain productivity and ensure timely processing of work queues.
• Clarify documentation with physicians via query process and communicate edits to Epic.

Conoscenze

Medical coding

HIPAA compliance

Query resolution

Epic knowledge

Strumenti

3M Encoder

Codelink

Epic

Descrizione del lavoro

Assigns appropriate diagnosis/procedure codes based on clinical information contained in the patient’s medical record. Assigns appropriate ICD-10-CM, CPT and HCPCS codes as appropriate.

Supervises the Following Positions

Positions: N/A

Physical Requirements

• The ability to perform the duties and responsibility of the position, with or without reasonable accommodations for disabilities.
• The ability to consistently lift, push or pull loads of up to fifty (50) pounds. (Unless nursing 50)
• Sufficient strength, mobility and stamina to make frequent location and position changes, assist with patient care, and perform other physical activities of average difficulty.
• Candidates whose disabilities make them unable to meet the requirements will still be considered fully qualified if they can perform the essential functions of the job with reasonable accommodations.
• May be exposed to infectious or contagious disease.
• May have to handle emergency situations.
• May be subject to irregular hours.
• May be required to wear protective equipment such as eye protection, face protection, masks, sterile/nonsterile gloves, isolation gowns.
• May be exposed to toxic/caustic/chemicals/detergents.
• Physical activities include continuous sitting, and occasional walking, standing, bending, squatting, climbing, kneeling and twisting.
• Activity Conditions (Occasionally, Frequently, Continuously):
  • Sitting- Continuously
  • Walking- Frequently
  • Standing- Frequently
  • Bending-Frequently
  • Squatting - Occasionally
  • Climbing-Occasionally
  • Kneeling-Occasionally
  • Twisting-Occasionally
• Must be able to see with corrective eye wear.
• Must be able to hear clearly with assistance

Working Conditions

Primarily Works in a well-lighted and air-conditioned environment with period of heavy workload and stress. Works in various conditions.

Performance: Essential Functions

Decision Making: Ability to make decisions and takes appropriate action based on the information they have. Recognizes own limitations and consults with the supervisor, manager, or team member when appropriate.

Time Management: Works efficiently and manages duties to ensure that tasks are completed with accuracy and within the scheduled shift or reasonable amount of time.

Quality & Quantity: Demonstrates accurate, knowledge and skill to carry out job duties. Follows departmental work policies and procedures. Speed and consistency of output and time utilization of job duties.

Computer Knowledge & Electronic Equipment Use: Demonstrates ability to consistently utilize electronic equipment and online computer programs to perform job duties, including electronic documentation, and order entry.

Resource Utilization: Consistently utilizes and maintains supplies and equipment to minimize lost charges and unnecessary equipment repair-replacement.

Confidentiality: Adheres to established policies on privacy and security requirements for compliance with the Health Insurance Portability and Accountability Act (HIPAA), as applicable by Shannon Policy.

Performance: Position Specific Essential Functions

• Identifies principal diagnoses and procedures on all patient records; codes all appropriate diagnoses and procedures using ICD-10-CM, CPT codes, HCPCS, and modifiers and condition codes, when appropriate, using software via 3M, Encoder and Codelink.
• Audit all Locum Tenens charges and Level 5 services
• Open Help Tickets when needed according to department guidelines
• Maintain productivity standards as defined by manager
• Ensures work queues are processed in a timely and efficient manner
• Works cooperatively in a group setting as appropriate
• Clarifies documentation issues with physicians/providers via use of query process
• Inform appropriate team members of custom edits to be added to the Epic software
• Maintain coding certification, if applicable
• Work reports to better serve the business office.
• Observes, reinforces and is compliant with all clinic policies and procedures.
• Maintain current knowledge of job duties and appropriate business office procedures.
• Attends seminars, training sessions, and meetings as needed or requested.
• Distributes memos and information to employees, staff and physicians
• Perform other duties, as assigned.
• Serves as a liaison between administration, physicians, nurses, staff and other departments
• Reports problems or issues affecting office or clinic to administrator or other department managers
• Assist in implementing and communicating all coding and reimbursement changes to physicians and staff; assist staff with coding reimbursement problems.
• Keep abreast of current changes in coding requirement of third party payers.
• One year of experience in Physician Coding
• One year of experience in a Medical Office