Coding Reimbursement Specialist II

Tryon Medical Partners; United States; Hybrid; USD 55,000 - 90,000; Full time

Job summary

Tryon Medical Partners is seeking a Certified Professional Coder to join our RCM team in a full-time hybrid or remote role. You will review charts, assign CPT and ICD-10 codes, and ensure accurate billing in accordance with AMA guidelines.

The ideal candidate has at least three years of coding experience, a CPC certification, and strong knowledge of medical terminology, payer rules, and regulatory guidelines. Monday–Friday 8 am to 5 pm schedule.

Qualifications

• Three+ years of CPT/ICD-10 coding experience required.
• CPC certification preferred; active certification and CEUs required.
• Strong knowledge of medical terminology, anatomy, and physiology.

Responsibilities

• Performs initial charge review to determine codes for physician services.
• Interprets notes and reports to assign CPT and ICD-10 codes per AMA guidelines.
• Enters data into the TMP billing system and codes with modifiers as needed.
• Adheres to timeliness guidelines and communicates with the team to ensure targets are met.
• Contacts physicians via query protocols to ensure proper coding and billing.

Skills

CPT coding

ICD-10 coding

Medical terminology

Regulatory knowledge

Payer rules

Education

High school diploma

CPC Certification

Active certification maintenance

Job description

Certified Professional Coder

Job Summary:

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

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.