What are the responsibilities and job description for the Coding Reimbursement Specialist III position at Aurora Health Care?
Essential Functions
- Subject matter expert in at least one specialty, e.g., oncology, gynecology, surgical coding (not including primary care procedures) and infusion coding including chemotherapy and infusions involving multiple drugs.
- Assigns CPT and ICD codes in cases of moderate to high complexity.
- Reads, interprets and assigns CPT codes from provider documentation, e.g., infusion record or operative report.
- Performs 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.
- Performs reconciliation process to ensure all charges are captured.
- Processes automated or manually enters charges into applicable billing system.
- Researches and analyzes coding and payer specific issues.
- Processes charges on a timely basis and communicates with team members and practice management on an ongoing basis.
- Communicates with providers related to coding issues that are of moderate to high complexity. Including face to face interaction, explaining coding rationales, and education with providers.
Education, Experience And Certifications
- High School Diploma or GED required.
- Minimum of 2 years of coding experience required.
- CPC or equivalent coding credential required. Maintain coding certification (CPC, CCS, RHIT, RHIA).
- Extensive knowledge of coding, medical terminology, anatomy, and physiology. Extensive knowledge of and the ability to apply the payer specific rules regarding coding, bundling, and adding appropriate modifiers.
Physical Requirements
- Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.
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