Coding Specialist (31954)

The Specialty Alliance; Austin (TX); On-site; USD 58,000 - 92,000; Full time

Job summary

GI Alliance seeks an experienced Certified Professional Coder (CPC) to interpret and bill physician charges for services. This role requires accurate CPT/ICD-10 coding, data entry, and adherence to payer rules.

You will review documentation, coordinate with physicians and reimbursement staff, and ensure all billable services are captured. A background in EMR systems and recent coding certification is essential to success.

Qualifications

• Education: High school diploma or GED; CPC certification required (AAPC).
• Experience: 1–4 years entry level; >4 years with supervision if needed.

Responsibilities

• Perform initial charge review to determine ICD-10 and CPT codes for physician services.
• Enter patient data from demographics and insurance plans into billing systems.
• Interpret notes and reports to assign CPT/ICD-10 coding and ensure accurate billing.
• Enter data into the Billing System with diagnoses, modifiers, and provider information.
• Review physician documentation to ensure compliance with payer rules and regulations.
• Collaborate with Reimbursement staff to respond to coding/billing inquiries.
• Scrub claims to ensure compliance and accuracy before submission.

Skills

CPC (AAPC)

EMR experience

Medical coding

Data entry

Microsoft Office

Attention to detail

Education

High school diploma or GED

AAPC CPC certification

Tools

gPM system

Job description

GI Alliance is seeking a experienced Certified Professional Coder (CPC).

Position purpose

Performs various duties to accurately interpret and bill physician charges for physician services. Enters into the Billing System appropriate CPT and ICD-10 codes and bills charges.

Responsibilities/Duties/Functions/Tasks

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Assists in entering data from impatient facesheets including but not limited to demographics, insurance plans, etc.
• 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.
• Enters appropriate data into gPM by selecting the appropriate codes, diagnosis, modifiers, Anesthesiologist, CRNA, pathology, and provider information to complete the process.
• Contacts physicians through management 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.
• Monitors and follows up to ensure all services that can be billed are captured and coded for billing.
• Responsible for ensuring the batch processes for all coded charges.
• 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 GI Alliance physicians' and pathology services.
• Works in coordination with other members of the Central Billing Office as necessary.
• Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.
• Responsible for scrubbing claims in order to submit compliant, truthful, and correct coding based on payer rules.
• Performs other related duties as required and assigned.

Qualifications

Education: High school diploma or GED completion is required. Professional Coding Certification with American Academy of Professional Coders AAPC: Certified Professional Coder (CPC) is required.

Experience: Experience working with EMR and in medical coding preferred.

Requirements For Level I Status

• Entry level (1-4 years experience) and/or meet the basic requirements of the job with the need for additional supervision.
• Excess of 4 years experience if meeting only the basic requirements of the job with need for additional supervision.

Performance Requirements

• Good working knowledge of medical terminology and anatomy.
• Knowledge of current third party billing and collection regulations and requirements.
• Good interpersonal skills and written and verbal communication skills.
• Ability to gather and interpret clinical data.
• Ability to utilize Microsoft Office and alpha numeric data entry.
• Strong attention to detail and decision making skills.

GI Alliance is an Equal Opportunity Employer. We are committed to creating an inclusive, welcoming, and equitable work environment. Our company values and celebrates the diversity of our physicians, staff and patients. We firmly believe our service is greatly enriched by our diversity of thought, experience, perspective, culture, and background.

Please Note: All job offers are contingent on the successful completion of pre-employment criminal history check.

EEO/AA-M/F/disabled/protected veteran