Revenue Cycle Coding Specialist

HealthPartners; Minnesota; Presencial; USD 55.000 - 75.000; Jornada completa

Descripción de la vacante

HealthPartners in Minnesota seeks a Revenue Cycle Coding Specialist to abstract and enter charges for provider services across hospital and ambulatory settings. This role codes CPT/HCPCS/ICD-10, performs audits, and supports payer regulations to ensure accurate reimbursement.

The ideal candidate holds a coding certification and a HIM-related degree or equivalent experience, with strong documentation and auditing skills. Epic experience preferred.

Formación

• Requires completion of a coding education program, degree in Health Information Management or related field, or equivalent coding experience.
• Must hold an approved coding certification (CCA, COC, CCS, CPC, CCS-P, RHIT, or RHIA).
• Knowledge of CPT, HCPCS, ICD-10 CM coding guidelines, anatomy, physiology and medical terminology; intermediate MS Office skills.

Responsabilidades

• Confirms documentation supports charges; assigns accurate CPT, HCPCS and ICD-10 CM codes, modifiers and fees according to regulations.
• Provides clinician feedback on coding trends and complex billing issues.
• Reviews denials and conducts retrospective coding audits.
• Collaborates with Compliance, Internal Audit and Education teams on coding reviews and new clinician onboarding.
• Performs other duties as assigned.

Conocimientos

CPT coding

HCPCS coding

ICD-10 coding

HIM knowledge

MS Office

Educación

Coding education program or HIM degree

Herramientas

Epic experience

Descripción del empleo

Park Nicollet is hiring a Revenue Cycle Coding Specialist. The Revenue Cycle Specialist abstracts and enters charges for provider services that may occur in the hospital inpatient/outpatient, ambulatory surgery, or other system wide outpatient facilities. Assigns appropriate CPT codes, ICD-10 codes, modifiers, fees and other third-party payer regulations in accordance with all associated contracts in an accurate and timely manner to ensure appropriate reimbursement. Completes retrospective chart documentation audits relative to denied claims, provider request and patient complaints.

MINIMUM QUALIFICATIONS:

• Education, Experience or Equivalent Combination:
  • Requires completion of a coding education program, degree in Health Information Management or related field, or equivalent coding experience.
• Licensure/ Registration/ Certification:
  • Must hold an approved coding certification (CCA, COC, CCS, CPC, CCS-P, RHIT, or RHIA).
• Knowledge, Skills, and Abilities:
  • Knowledge in using CPT, HCPCS, ICD-10 CM coding guidelines, rules and regulations, anatomy, physiology, basic disease processes and medical terminology
  • Intermediate knowledge of Microsoft Office Suite.
  • Must be able to work independently, apply time management and critical thinking skills, and have strong decision-making skills.

PREFERRED QUALIFICATIONS:

• Education, Experience or Equivalent Combination:
  • One year coding experience
  • Epic experience
  • Experience working with online coding resources and other related software programs.
  • Strong E & M coding experience.
• Licensure/ Registration/ Certification:
  • N/A
• Knowledge, Skills, and Abilities:
  • Ability to present and communicate information in either individual and/or group settings in a professional and confident manner.

ESSENTIAL DUTIES:

1. (75%) - Confirms documentation supports the charges selected by clinician and provides feedback. Assigns accurate CPT, HCPCS and ICD-10 CM codes, modifiers, and fees according to billing and payer regulations. Complete all CCI/LCD/NCD edits, Epic coding edits to ensure accurate coding through coding associated charge review work queue strategies and rules. Maintains a current knowledge of annual coding changes, regulations and legislative communications impacting coding and billing practices. Evaluate and understand the impact of annual code changes for all liaison specialties and provide appropriate communication. Performs and understands risk adjustment models and data validation based on coding guidelines and best practices.
2. (5%) – Provide feedback and education to clinicians based on identified coding trends, chart reviews and other opportunities. Works closely with clinicians and /or representatives from medical departments to discuss complex billing/coding issues. Understand the use of and assist with the content of charting tools (smart sets, templates, and preference lists).
3. (5%) – Work coding related denials and provide feedback to clinicians and/or departments based on identified denial trends. Conducts retrospective coding audits relative to denied claims, clinician requests, and/or patient complaints.
4. (5%) – Works closely with Compliance Operations and Internal Auditing teams. (example: annual provider reviews).
5. (5%) – Partners with Coding Education and Data Analyst regarding documentation and coding reviews, coding audits, including providing feedback to new and existing clinicians. Assists in strategies regarding New Clinician Orientation and onboarding new operational leaders regarding mid-revenue cycle workflows.
6. (5%) – Other duties as assigned.

*Job description rankings/percentages are intended to reflect normal averages over an extended period of time, and are subject to daily variances. Quality and efficiency standards should at no time be compromised to meet the average expectations expressed above. Job descriptions are subject to change to accommodate organization or department needs