Job Summary:

Under supervision, the Coding Specialist provides real-time coding and is committed to providing and delivering a superior quality service to our patients. This position will review medical records and assign accurate diagnosis and procedure codes based on the patients medical record. The Coding Specialist is responsible for assigning accurate diagnosis and procedure codes to the patient's health information records, for ophthalmic medical practice. This responsibility requires appropriate code assignment for physician-documented patient diagnoses, conditions, and procedures; utilizing various coding classification schemes including ICD- 10CM (may include PCS), and HCPCS/CPT.

Duties and Responsibilities:

• Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes.
• Ensure codes are accurate and sequenced correctly in accordance with government and insurance requirements.
• Accurately documents chart errors according to practice protocols.
• Code minor and major surgical procedures (intravitreal injections/retina surgeries)
• Assists with initiating billing and re-billing for various procedures using appropriate CPT/ ICD coding.
• Conduct internal chart audits
• Partner with cross-functional teams to resolve patient billing questions and inquiries
• Respond timely to insurance company inquiries in company systems
• Monitor aging accounts report to identify accounts with delinquent items to action
• Handle business office phone calls as needed
• Represent the practice in a professional manner and treat all patients, both internal and external, in a courteous manner
• Performs other tasks as required.

Skills/Competencies:

• Basic understanding of algebraic principles.
• Knowledge of minor and major surgical procedures (intravitreal injections/retina surgeries)
• Understands Medicare and other common insurance requirements for quality reporting in order to help practice comply with payer requirements.
• Knows required components of examination for appropriate coding (ICD-10 selection/CPT coding) to ensure all elements are accurately completed.
• Training and understanding of HIPAA requirements and the importance of maintaining patient confidentiality.
• Ability to learn Nextgen/Nextech quickly and efficiently
• Strong, professional interpersonal skills.
• Understanding of medical terminology and/or ophthalmic terminology
• Maintain calm and positive attitude and maintain a professional demeanor in stressful situations. Have the ability to respond to changing workload and work environment.
• Excellent verbal and written communication.
• Management of multiple projects simultaneously.
• Strong computer skills with a high degree of accuracy on data entry and attention to detail

Must maintain patient confidentiality in accordance with clinic policy and HIPPA guidelines.

Education Requirements

• High school diploma or GED equivalent
• College degree preferred

Experience Requirements:

• Minimum of two years experience in a medical office, preferably an ophthalmology office.
• Experience in medical billing and knowledge of CPT/ICD-10 coding required
• Scribe certification preferred
• Ophthalmic coding preferred

Physical Abilities:

• Must be able to multi-task and work in a fast-paced environment.
• Work may require sitting for long periods of time
• Requires manual dexterity sufficient to operate a keyboard, calculator, telephone and other office equipment.

Note:

This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.