Medical Coding Specialist

Position Title: Medical Coding Specialist

Report To: Medical Billing & Coding Manager

Department: Finance

Employment Type: Full-Time [FLSA Status: Hourly Non-Exempt]

Work Location: In Office (possible opportunity for Hybrid, pending work performance)

Job Summary:

The Medical Coding Specialist will evaluate medical records and charge tickets to ensure completeness, accuracy, and compliance with the ICD-10-CM, CPT, CPT II, and HPCS Level II. While much of the coding mainly is for primary care, there will also be records and charge tickets for wound care and behavioral health requirements. The Specialist will also provide technical guidance and training on medical coding to physicians and staff.

Duties/Responsibilities:

• Evaluates medical record documentation and records for correct coding to optimize reimbursement
• Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10-CM and CPT codes
• Reviews claims for completeness and accuracy before reimbursement submission to minimize claim denial
• Demonstrates understanding of clinical documentation that drives high-quality comprehensive coding and uses knowledge to effectively augment clinical providers’ training in compliant documentation practices that support accurate coding
• Maintains current knowledge of health care reimbursement methodologies and applies this knowledge to daily practice; and understands clinical indicators that support accurate and complete coding
• Effectively communicates with and acts as a resource for staff to resolve documentation issues as they arise to ensure accuracy of coding
• Follows chain of command if coding clarification is warranted
• Contacts responsible practitioner if coding clarification is warranted
• Maintains a working knowledge of CMS and Medicare/Medicaid/Insurance payer guidelines to assure use of correct coding policies and guidelines
• Responsible for generating and scrubbing claims for accuracy
• Responsible for being in compliance with Health Insurance Portability and Accountability Act (HIPAA)
• Responsible for working knowledge of insurance policy guidelines and reimbursement processes and reporting data for merit-based incentive payments
• Performs other duties as assigned

Required Skills/Abilities:

• Knowledge of ICD-10-CM, CPT, and HCPC Level II coding guidelines
• Understanding and knowledge of medical terminology
• Ability to exercise independent judgment
• Ability to maintain confidentiality
• CPC certification from a recognized agency required
• 3 years of clinical coding experience preferred
• Strong attention to detail and high level of accuracy required
• Computer literate with skills in Microsoft office (Word/Excel)
• Knowledge of Federal and State regulatory requirements and standards
• Strong written and verbal skills, along with the ability to work closely with a wide range of professionals or a multi-disciplinary team
• Can successfully pass background checks & drug screen
• Valid driver’s license

Education and Experience:

• High School Diploma or General Education Degree required
• Certified Professional Coder (CPC) preferred
• 3 years of experience in medical coding experience
• Specific experience coding for Wound Care and Behavioral health coding is preferred
• Proficient in English, spelling, keyboarding, computers, business, or office practices
• Bilingual experience is preferred
• Strong organizational skills

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer
• Must be able to lift up to 15 pounds at times

Job Type: Full-time

Pay: $13.50 - $25.00 per hour

Expected hours: 25 – 40 per week

Benefits:

• Flexible schedule
• Paid time off

Work Location: Hybrid remote in Wichita, KS 67202

Salary : $14 - $25