Coding Reimbursement Specialist II

BlueFire Workforce Solutions; Charlotte (NC); Hybrid; USD 51,000 - 65,000; Full time

Job summary

Tryon Medical Partners is seeking a Coding Reimbursement Specialist II to interpret and bill physician charges by entering CPT, ICD-10 and modifiers into the Billing system. This full-time hybrid or remote position will support the RCM team, Monday to Friday 8 am to 5 pm.

The role requires three or more years of CPT/ICD-10 coding experience, advanced medical terminology knowledge, and active certification; CPC preferred.

Qualifications

• Three+ years of CPT and ICD-10 coding of physician services.
• CPC certification required; CEUs ongoing during employment.
• Advanced medical terminology knowledge.
• Familiar with payer-specific coding rules and modifiers.
• Understanding of NCDs and LCDs and regulatory guidelines.

Responsibilities

• Perform initial charge review to determine ICD-10 and CPT codes.
• Interpret notes and documents to assign CPT/ICD-10 codes per AMA guidelines.
• Enter codes, diagnoses, and modifiers into the billing system.
• Adhere to timeliness and communicate with team to meet guidelines.
• Query physicians to confirm procedures and coding accuracy.
• Review patient logs to ensure charges are captured.
• Ensure compliance with third-party and regulatory guidelines.
• Collaborate with Reimbursement staff on coding inquiries.
• Perform other related duties as required.

Skills

CPT/ICD-10 coding

Medical terminology

Payer rules

Team collaboration

Education

High school diploma or GED

CPC Certification

Job description

Coding Reimbursement Specialist II Remote

Full Time

Revenue Cycle Management

Mid Level

Our Client Tryon Medical Partners is hiring a Coding Reimbursement Specialist II

Job Summary:

The Coding Reimbursement Specialist II performs various duties to accurately interpret and bill physician charges for physician services by entering into the appropriate CPT, ICD-10, and modifiers into the Billing system.

(This is a full-time hybrid or remote position that will support the RCM team, Monday to Friday 8 am to 5 pm)

Primary Job Responsibilities/Tasks may include, but not limited to:

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services, according to guidelines established by the AMA.
• Enter appropriate data into the TMP billing system by selecting the appropriate codes, diagnosis, modifiers, to complete the charge process.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Contacts physicians through query protocols regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for TMP physicians' services.
• Performs other related duties as required and assigned.

Requirements:

Education and Certifications:

• High school diploma or GED completion is required.
• A minimum of three (3) years’ experience with CPT and ICD-10 coding of physician services required.
• Coding certification required. CPC Certification preferred. Must maintain active certification and required CEUs during employment tenure.
• Advanced working knowledge of medical terminology, anatomy, and physiology required.
• Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers.
• Understanding of and familiarity with regulatory guidelines including NCDs and LCDs.

Experience:

• Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, and Dermatology preferred.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Advanced knowledge of the ICD-10 CM/PCS and CPT/HCPCS coding systems and conventions.
• Advanced knowledge of, but not limited to, Official Coding Guidelines and methodologies.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Good interpersonal skills and a basic understanding of team concept.
• Ability to gather and interpret clinical data.
• Ability to work independently in a fast-paced environment.

Physical Requirements:

• Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
• Must be able to lift and support weight of 35 pounds.
• Ability to concentrate on details.
• Use of computer for long periods of time

Hourly Rate - Based upon Experience:

• Minimum: $24.64/hour
• Midpoint: $27.68/hour
• Maximum: $31.17/hour