Senior Coding Specialist (Multi-Specialty)

Coding Strategies, Inc.; Town of Texas (WI); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Coding Strategies, Inc. is seeking a Senior Coding Specialist for a remote US-based role. The candidate should have multispecialty coding experience (surgery, Interventional Radiology, and E/M) and a proven ability to abstract ICD-10-CM, CPT, and HCPCS codes from medical records.

The role requires a CPC/COC/CCS/CCS-P/RHIT/RHIA certification and the capacity to maintain high accuracy while delivering timely, compliant coding results in a largely remote setting.

Qualifications

• Assign ICD-10 CM and CPT codes with modifiers for services in various settings.
• Research coding guidelines and documentation to ensure accurate code assignment.
• Maintain 95% accuracy rate and quality of work.
• Certified coder through AAPC or AHIMA.
• Ability to work independently and meet productivity goals.

Responsibilities

• Abstract all E/M, CPT, HCPCS, ICD-10-CM from documentation.
• Enter data into coding software and Excel reports.
• Provide feedback via comments and summaries; suggest documentation improvements.
• Review edits and denials and assist with rebilling when needed.
• Identify trends in provider documentation and communicate improvements.

Skills

ICD-10-CM coding

CPT coding

EMR systems

Analytical writing

Interpersonal communication

Independent work

MS Word / Excel / PowerPoint

Education

High School Diploma or GED

AAPC or AHIMA certification (CPC/COC/CCS/CCS-P/RHIT/RHIA)

Tools

MS Word

Excel

PowerPoint

Job description

*This role is a remote US based position

*The ideal candidate will have a strong multispecialty background to include surgery, Interventional Radiology and E/M

SCOPE/GENERAL PURPOSE OF JOB:

The Senior Coding Specialist is responsible for abstracting all E/M, CPT, HCPCS, ICD-10-CM, modifier, units from the medical record documentation.Other responsibilities include accurately entering data into coding/billing software and/or Excel reports.Performing accurate coding using applicable guidelines and facility protocols and communicating with staff and/or providers as needed.Provide written feedback of coding results as needed in the form of comments, summary of findings and recommendations.Ensure compliance with federal and state laws, regulations and standards related to health information and coding principles.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Assign ICD-10 CM and CPT codes with modifiers for services provided in the facility environment (Ancillary, ED, Evaluation and Management, Observations, Outpatient surgeries, and/or Professional fee coding) depending on the specific client assignment.
• Demonstrates thorough understanding and ability to research all aspects of coding, compliance, documentation and reimbursement for assigned clients and specialties.
• Review the medical record and all applicable documentation to determine the appropriate codes to assign for the services and diagnoses.
• Ensures diagnosis codes meet local and national medical necessity guidelines.
• Utilize coding resources along with any other applicable reference material available to ensure accuracy in coding for all assigned services.
• Maintains and delivers accurate client worksheets and deliverables.
• Must maintain accurate records of time spent.
• Monitors clients for potential compliance concerns and communicates concerns with leadership.
• Demonstrates the technical competency to use the facility encoder as it interfaces with the hospital/physician mainframe and/ or EMR in remote setting.
• Demonstrates proficiency with Microsoft Office Applications in using required computer systems with minimal assistance.
• Review and resolve coding edits and denials.Assists with rebilling accounts when necessary.
• Assist with periodic client updates and provider education/documentation improvement.
• Identifies trends with provider documentation provides proactive documentation improvement suggestions.
• Maintain a working knowledge of various laws, regulations and industry guidance that impact compliant coding.
• Must meet all coder productivity and quality goals.
• Maintain a 95% accuracy rate.
• Other duties as assigned.

EDUCATION AND/OR EXPERIENCE:

• High School Diploma or GED required.
• Minimum of four (4) years professional fee coding job experience unless otherwise noted by management.
• Ability to code multiple specialties as a Subject Matter Expert with a sustained accuracy and productivity rate.
• Ability to do research on coding questions and present as needed to team.
• Must be a certified coder through AAPC or AHIMA (CPC, COC, CCS, CCS-P, RHIT, RHIA)
• Knowledge of ICD, CPT, HCPCS, Anatomy, Physiology, Medical Necessity, Modifiers, and Denials.
• Excellent writing and interpersonal sills
• Ability to work independently.

QUALIFICATIONS:

Knowledge Areas:

• Organizational policies and procedures.
• Knowledge of coding documentation and reimbursement.
• Health care administration and business principles.
• Clinical processes and procedures as they relate to healthcare coding.
• Health insurance policies and procedures, particularly as they relate to claims processing.
• Apply knowledge of anatomy, clinical disease process and medical terminology to ensure accurate procedure, supply and diagnosis code assignment.

Skills:

• Ability to communicate effectively and professionally with coding staff, clinical staff and administrative staff.
• Must be highly detailed with outstanding analytical and writing skills and the ability to communicate professionally with clients and employees.
• Ability to establish and maintain effective professional working relationships with all employees and clients.
• Requires analytical, organizing, planning and problem-solving abilities
• Exercises initiative, judgment, discretion and decision-making to achieve business unit objectives.
• Identifies problems and suggests resolution.Must be competent and comfortable with MS Word, Excel & PowerPoint.