Coding Specialist - Revenue Cycle Management

McLeod Health; South Carolina; On-site; USD 42,000 - 62,000; Full time

Job summary

McLeod Health is seeking a professional coder to maintain accurate coding for professional claims and ensure timely reimbursement. You will review documentation to verify CPT, HCPCS, and ICD-10 CM codes in line with compliance guidelines and assist with denials and appeals to optimize revenue.

The role requires 1–2 years of coding and billing experience, CPC or CPC-A certification, and strong Excel/Office skills. Travel to satellite offices may be needed as part of duties.

Qualifications

• 1–2 years of coding and billing experience preferred.
• CPC or CPC-A certification required; if not obtained, certification within 1 year of hire.
• High School Diploma or equivalent required.

Responsibilities

• Code professional claims for physicians or practice-based entities.
• Review documentation for accurate CPT, HCPCS, and ICD-10 CM codes per guidelines.
• Maintain CEUs for AAPC certification.
• Assist billing with denials/appeals to optimize reimbursement.
• Travel may be required to satellite offices.

Skills

Medical coding

CPT/HCPCS/ICD-10

Payor knowledge

Attention to detail

Education

CPC Certification

High School Diploma

Tools

Microsoft Excel

Microsoft Office

Job description

Job Description

• Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values.
• Responsible for coding claims for professional fees for practice based physicians or other entities.
• Reviews professional documentation for accurate CPT, HCPCS, and ICD-10 CM coding that adheres to coding compliance guidelines for accurate, timely, and consistent codes.
• Maintain CEUs for AAPC Membership/Certification.
• Ability to look up CPT, HCPCS, and ICD-10 CM codes from online service or using traditional coding references.
• Manage time to meet productivity standards to ensure coding is within departmental goal.
• Assist billing department with coding denials/appeals from various payors to ensure optimum reimbursement for documented services.
• Maintains knowledge of payor coding and billing guidelines for assigned specialties.
• Communicates coding trends or problems identified as impacting reimbursement to the management team.
• Able to serve as a resource to other coding specialists.
• Develop working relationship with physicians/providers and office staff.
• Regularly meets with the Coding Manager to discuss and resolve coding issues or obstacles.
• Knowledge of billing guidelines and requirements for all payors.
• Travel may be required to satellite offices and/or practices.

Work Schedule: 80 Hours bi-weekly

Qualifications /Training:

A minimum of 1-2 years of coding and billing experience preferred. A computer background in Microsoft Excel/Office. Oral and written communication skills as well as analytical and organizational skills.

Licenses/Certifications/Registrations/Education:

CPC or CPC-A Certification thru the AAPC or other nationally recognized coding credentialing is required. If certification is through another nationally recognized credentialing entity, employee must obtain AAPC certification within one year of hire.

Minimum of a High School Diploma or equivalent from an accredited school is required

About Us

Founded in 1906, McLeod Health is a locally owned and managed, not for profit organization supported by the strength of more than 900 members on its medical staff and more than 2,900 licensed nurses. McLeod Health is also composed of approximately 15,000 team members and more than 90 physician practices throughout its 18-county service area . With seven hospitals, McLeod Health operates three Health and Fitness Centers, a Sports Medicine and Outpatient Rehabilitation Center, Hospice and Home Health Services. The system currently has 988 licensed beds , including Hospice and Behavioral Health. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health.

About The Team

We are an equal opportunity employer.