Coding Specialist II

Medical College of Wisconsin; Orlando (FL); Remote; USD 50,000 - 80,000; Full time

Job summary

An innovative healthcare institution is seeking a Coding Specialist II to ensure accurate coding and billing processes. This remote role offers the opportunity to work closely with physicians and administrative staff, enhancing revenue and reducing claim denials. The ideal candidate will have a strong understanding of CPT and ICD-10 CM coding, along with excellent communication skills to educate providers and maintain effective relationships. Join a dynamic team that values detail-oriented professionals who are committed to excellence in healthcare billing practices.

Qualifications

• Knowledge of CPT and ICD-10 CM coding is essential.
• Detail-oriented with strong computer skills and ability to work with teams.

Responsibilities

• Perform coding and related duties accurately and timely.
• Coordinate professional service billings for selected clinical departments.
• Resolve coding and reimbursement issues with staff and physicians.

Skills

CPT Coding

ICD-10 CM Coding

Charge Processing

Reconciliation of Charges

Claim Denials Resolution

Provider Education

Detail Oriented

Effective Communication

Education

Certification in Medical Coding

Associate's Degree in Health Information Technology

Job description

As aCoding Specialist II,you will perform coding and related duties using established billing office policies in an accurate and timely manner. Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff. Coordinates professional service billings for selected clinical departments.

This role is 100% remote for the following states: WI, FL, MN, NC, TN, & TX.

Responsibilities:

CHARGE PROCESSING

• Assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation. (Inpatient/Emergency Department abstraction, ambulatory coding and/or surgical/procedural coding)
• Resolve edits for electronic charges, following established policies and procedures to insure that all data elements (claim requirements – CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are applied.
• Charge Entry as needed.

RECONCILIATION OF CHARGES:

• Monitor charge flow and act as a liaison with managers, department administrators and other billing personnel toassure consistent and accurate charge flow. Work with clinic staff and physicians regarding missing or unclear information that is required for billing.

CLAIM DENIALS / BILLING ISSUES

• Identify, report, and resolve coding and reimbursement issues. Working with physicians, department administrators and other billing office staff, including reimbursement staff. Identify opportunities to reduce denials and enhance revenue.

PROTOCOLS

• Develop and maintain all protocols related to their assigned areas.

PROVIDER EDUCATION

• Maintain understanding all Teaching Physician and provider documentation policies.
• Actively participate in new provider orientations.
• Note and address trends in provider documentation that may impact coding and billing.

Knowledge – Skills – Abilities

Working knowledge of CPT and ICD-10 CM coding. Understanding of medical insurance guidelines and governmental policies. Progressive computer skills. Detail oriented. Ability to establish and maintain effective working relationships with the team and department staff (including administrative staff and faculty). Meet or exceed established production rate and performance standards.