Lead Coding Reimbursement Specialist - Revenue Cycle

Atrium Health; Charlotte (NC); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare provider in Charlotte seeks a Lead Coding Reimbursement Specialist to perform high complexity coding duties. This role requires expertise in multiple coding areas, mentoring teammates, and ensuring compliance with coding guidelines. Ideal candidates will have extensive knowledge of medical terminology and coding regulations, along with excellent communication skills.

Benefits

Paid Time Off programs

Health and welfare benefits

Flexible Spending Accounts

Educational Assistance Program

Qualifications

• 5 years of coding experience required.
• Maintains coding certification (CPC, CCS, RHIT, RHIA).

Responsibilities

• Assigns CPT and ICD codes in cases of high complexity.
• Develops and mentors teammates of the same or similar specialty.
• Conducts quality assurance reviews for a designated specialty.

Skills

Communication

Coding

Medical Terminology

Anatomy

Physiology

Education

High School Diploma or GED

CPC or equivalent coding credential

Job description

Lead Coding Reimbursement Specialist - Revenue Cycle

Charlotte, NC, United States
Job ID: 154124
Job Family: Medical Records Services
Status: Full Time
Shift: Day
Job Type: Regular
Department Name: 21041017241270-Charge Capture - Surgery/Medical Education

Accepting applicants from the following states: AL, CO, FL, GA, ID, KS, KY, ME, MI, NC, SC, VA, VT

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

Premium pay such as shift, on call, and more based on a teammate's job

Incentive pay for select positions

Opportunity for annual increases based on performance

Benefits and more

Paid Time Off programs

Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability

Flexible Spending Accounts for eligible health care and dependent care expenses

Family benefits such as adoption assistance and paid parental leave

Defined contribution retirement plans with employer match and other financial wellness programs

Educational Assistance Program

Job Summary

Performs coding duties of high complexity judgment and scope demonstrating mastery of specialty coding that enables them to provide support to physicians.

Essential Functions

• Subject matter expert in multiple areas of coding, e.g., surgery.
• Assigns CPT and ICD codes in cases of high complexity, judgment and scope.
• Reads, interprets and assigns CPT codes from provider documentation, e.g., operative report.
• Codes ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered.
• Appends all modifiers.
• Ranks CPT codes when multiple codes apply.
• Assigns Evaluation and Management (E/M) codes.
• Reconciles processes to ensure all charges are captured.
• Automates or manually charges into applicable billing system.
• Researches and analyzes coding and payer specific issues.
• Processes charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Communicates with providers, either verbally or in writing, related to coding issues that are of high complexity. Including face to face interaction, explaining coding rationales, and education with providers.
• Develops and mentors teammates of the same or similar specialty and serve as an internal resource.
• Conducts quality assurance reviews for a designated specialty to determine additional training opportunities.

Physical Requirements
Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.
High School Diploma or GED required. 5 years of coding experience required. CPC or equivalent coding credential required. Maintains coding certification (CPC, CCS, RHIT, RHIA). Extensive knowledge of coding, medical terminology, anatomy, and physiology. Extensive knowledge of and the ability to apply the payor specific rules regarding coding, bundling, and adding appropriate modifiers. In depth knowledge of claim editing rationale and revenue cycle. Basic knowledge of Relative Value Units. Understanding of and familiarity with regulatory guidelines including NCDs and LCDs. Excellent written and verbal communication skills.