Coding Specialist

Company Description

With 150 locations in 17 states, Pinnacle Dermatology is the largest multi-state female-founded and owned dermatology network in the U.S. At Pinnacle Dermatology we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you! Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees.

Position Summary

This position works with a professional team of physicians and other staff who are trained in the medical and surgical specialty of dermatology with the purpose to be patient focused with the objective of delivering superior patient care and ensuring a positive patient experience and outcome.

The Billing/Coding Specialist is responsible for the billing/coding needs of all QDP practices and providers, as assigned. This position is supervised by the Coding Team Lead and of Revenue Cycle Manager.

Qualifications

• Knowledge of ICD-10-CM and CPT coding guidelines; medical terminology; anatomy and physiology; state and federal Medicare reimbursement guidelines.
• Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.
• Ability to read and interpret medical procedures and terminology.
• Ability to exercise independent judgment.
• Excellent written and verbal communication skills to prepare reports and related documents and to maintain working relationships with physicians and other staff.
• Excellent oral and written communication skills, ability to think critically and strategically
• Be able to multitask, prioritize, and manage time efficiently while in a remote working environment.
• Ability to maintain a high level of integrity and confidentiality of medical information.

Education and/or Experience Requirements

• High school graduate or GED.
• Certified Professional Coder (CPC), Certified Professional Coder-Apprentice (CPC-A), Certified Dermatology Coder (CDC), or other applicable coding certification.
• 0-3 years of experience in medical coding/reimbursement; experience with dermatology coding/billing is a plus.
• Mod Med/EMA practice management system experience preferred.
• Must be located in one of the following states:
  • AL, AZ, CA, DE, FL, GA, IL, IN, MD, MI, MN, MS, NC, NE, NJ, OH, OK, OR, PA, SC, TN, TX, VA, VT, WI, or WV.

Essential Responsibilities

• Evaluates medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflects and supports outpatient visits and to ensure that data complies with legal standards and guidelines.
• Review and audits medical records for correct CPT, ICD-10, and HCPCS codes for multiple providers in each practice throughout the Company.
• Monitors progress resulting from periodic audits and communicates with the Billing-Coding Team Lead or Revenue Cycle Manager.
• Maintains required CEUs.
• Performs coding and billing for multiple provider encounters.
• Analyze code, interpret and compile medical information/records to document patient condition and treatment.
• Code, prepare and submit clean claims to insurance companies via electronic and paper submissions.
• Monitor claim rejection queue, investigate and resolve claim rejections.
• Keep Billing-Coding Team Lead informed as necessary related to coding/billing/documentation.
• Adheres to Code of Conduct and Mission & Value Statement

Pinnacle Dermatology is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.