Coding Specialist II - Hospitalist Abstraction

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 join their remote team. In this pivotal role, you will perform coding duties and serve as the primary contact for various stakeholders, ensuring accurate and timely billing processes. Your expertise in CPT and ICD-10 CM coding will be vital as you resolve billing issues and enhance revenue opportunities. This position offers a chance to work collaboratively with physicians and administrative staff, contributing to a streamlined billing process. If you are detail-oriented and possess strong communication skills, this opportunity is perfect for you.

Qualifications

• Working knowledge of CPT and ICD-10 CM coding is essential.
• Ability to establish effective working relationships is crucial.

Responsibilities

• Perform coding and related duties accurately and timely.
• Coordinate professional service billings for selected clinical departments.

Skills

CPT Coding

ICD-10 CM Coding

Detail-oriented

Communication Skills

Problem-solving

Tools

Billing Software

Electronic Health Records (EHR)

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:

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 ensure 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 to assure 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. Work 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 assigned areas.

PROVIDER EDUCATION:

• Maintain understanding of 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.