Coding Specialist II - Dermatology/Nephrology Abstraction

Medical College of Wisconsin; United States; Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented Coding Specialist II to join their remote team. This role involves performing coding duties, coordinating professional service billings, and ensuring compliance with billing policies. You will work closely with physicians and administrative staff to resolve billing issues and enhance revenue. Ideal candidates will possess a strong understanding of CPT and ICD-10 CM coding, alongside excellent communication skills. If you thrive in a dynamic environment and are passionate about healthcare billing, this opportunity is perfect for you.

Qualifications

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

Responsibilities

• Perform coding and related duties accurately and timely.
• Resolve coding and reimbursement issues to reduce denials.

Skills

CPT Coding

ICD-10 CM Coding

Charge Processing

Reconciliation of Charges

Attention to Detail

Education

Certification in Medical Coding

Associate's Degree in Health Information Technology

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, support staff, and billing staff. The role involves coordinating 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:
2. Assignment or verification of CPT, ICD-10 CM coding, and modifiers based on documentation, including inpatient/emergency department abstraction, ambulatory coding, and surgical/procedural coding.
3. Resolve edits for electronic charges following established policies to ensure all data elements (claim requirements – CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are correctly applied.
4. Perform charge entry as needed.

1. Reconciliation of Charges:
2. Monitor charge flow and act as a liaison with managers, department administrators, and other billing personnel to ensure consistent and accurate charge flow. Work with clinic staff and physicians regarding missing or unclear billing information.

1. Claim Denials / Billing Issues:
2. Identify, report, and resolve coding and reimbursement issues. Collaborate with physicians, department administrators, and billing staff to identify opportunities to reduce denials and increase revenue.

1. Protocols:
2. Develop and maintain protocols related to your assigned areas.

1. Provider Education:
2. Maintain understanding of all Teaching Physician and provider documentation policies.
3. Participate actively in new provider orientations.
4. Monitor and address trends in provider documentation affecting 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, and attention to detail. Ability to establish and maintain effective working relationships with team members and department staff, including administrative staff and faculty. Must meet or exceed established productivity and performance standards.