Coding Specialist II

Medical College of Wisconsin; Orlando (FL); Remote; USD 45,000 - 70,000; Full time

Job summary

An established industry player is seeking a Coding Specialist II to manage and coordinate professional service billings effectively. This fully remote role allows you to work with physicians and administrative staff to ensure accurate coding and billing processes. You'll be responsible for charge processing, reconciliation, and addressing billing issues while maintaining protocols and educating providers. Join a dynamic team where your attention to detail and coding expertise will contribute to enhancing revenue and reducing claim denials. This is an excellent opportunity for those looking to make an impact in a supportive environment.

Qualifications

• Working knowledge of CPT and ICD-10 CM coding.
• Understanding of medical insurance guidelines and governmental policies.

Responsibilities

• Coordinate professional service billings for selected clinical departments.
• Resolve coding and reimbursement issues with physicians and billing staff.
• Monitor charge flow and collaborate with clinic staff for accurate billing.

Skills

CPT Coding

ICD-10 CM Coding

Detail-oriented

Computer Skills

Job description

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

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

Responsibilities:

1. Charge Processing:
   • Assignment or verification of CPT, ICD-10 CM coding and modifiers based on documentation (Inpatient/Emergency Department abstraction, ambulatory coding, and/or surgical/procedural coding).
   • Resolve edits for electronic charges, following established policies and procedures to ensure all data elements (claim requirements – CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are applied correctly.
   • Charge entry as needed.
2. Reconciliation of Charges:
   • Monitor charge flow and act as a liaison with managers, department administrators, and other billing personnel to ensure consistent and accurate charge flow. Collaborate with clinic staff and physicians regarding missing or unclear information required for billing.
3. Claim Denials / Billing Issues:
   • Identify, report, and resolve coding and reimbursement issues. Work with physicians, department administrators, and billing office staff, including reimbursement staff. Identify opportunities to reduce denials and enhance revenue.
4. Protocols:
   • Develop and maintain all protocols related to their assigned areas.
5. Provider Education:
   • Maintain understanding of all Teaching Physician and provider documentation policies.
   • Participate actively in new provider orientations.
   • Note and address trends in provider documentation that may impact coding and billing.

Knowledge, Skills, and 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 team and department staff, including administrative staff and faculty. Meet or exceed established production rate and performance standards.