The Coding Specialist reports to the Coding Manager and isresponsible for correct coding of professional services and upholding compliancestandards.

The Coding Specialist I isrequired to:

*Perform coding and related duties using establishedProfessional Billing Office and Coding Services policies in an accurate andtimely manner.Review medicaldocumentation and system generated charges or paper encounter forms.Appropriately assign CPT, ICD-9/ICD-10,HCPCS II, and modifiers based on documentation and payor requirements.

*Demonstrate a commitment to integrating codingcompliance standards into daily coding practices.Identify, correct and report codingproblems.

*Maintain current knowledge of coding, compliance andreimbursement procedures.Review currentliterature, newsletters, payor policy updates and coding manuals.

*Resolve coding edits and denials in a timelymanner.Identify opportunities to reducedenials and enhance revenue.

*Function as a resource to Professional Billing Officeunits and external customers.Researchand resolve coding inquiries.Makerecommendations for coding policy changes. Participate in the electronic or paperencounter form revision process to ensure correct coding standards aremet.

*Develop and maintain division specific codingprocedures.

*Complete special projects as assigned by managementwhich require defining problems, determining work sequences, summarizingfindings, and implementing required changes.

*Participate in coding education for providers andco-workers.

*High school diploma required

*Completion of a Coding Certificate program or HealthInformation Technology Program or work experience equivalent required.

*Experience in coding, billing, andknowledge of insurance reimbursement policies and regulations or equivalentexperience is preferred but not required if one has completed a CodingCertificate or Health Technology Program.

*Course work in anatomy and physiology,medical terminology is strongly preferred

*Coding Certification from American Academyof Professional Coders (AAPC) or American Health Information ManagementAssociation (AHIMA) is strongly preferred.Certification may include CPC, CPC-H, CCS, CCS-P.

• Proficient in ICD-9, ICD-10, CPT, HCPCS, and modifiers for coding of professional fee services.
• Working knowledge of anatomy and physiology, medical terminology and insurance reimbursement policies and regulations.
• Excellent written and verbal communication skills and the ability to prioritize and organize work to meet strict deadlines are required.
• Accuracy and attention to detail
• Proficient with computer applications (MS Office etc), good data entry skills

The Professional BillingOffice is located in the Charlestown Navy Yard campus.