Coding Specialist

All Employees of Premier Medical Group are required to demonstrate our core values of Integrity, Respect and Compassion throughout their employment with us, placing patients first. Our employees must commit to always acknowledging our patients positively; showing genuine concern for their needs, identifying themselves and how they and others on the team can help, keeping patients informed and offering thanks for choosing and trusting us with their healthcare needs.

Job Purpose: The Coding Specialist is a key member of the CBO Team. This position is responsible for providing coding audits for the physicians within the group, serving as a coding resource for the Central Billing Department, and reviewing charts to make coding recommendations for inpatient and outpatient claims.

Essential Functions:

• Follow Audit Calendar with emphasis on following PMG E&M Coding Compliance Plan.
  • Additional specialty or physician directed audits as requested.
• Coding hospital, surgical, and specialty procedures (CPT) and diagnosis (ICD-10) when coding is not completed by the provider.
• Reviewing and updating claims in the coding department hold work queues.
• Review of adjustment requests from CBO with coding-related denials or denial trends by payor.
• Provide overall support with respect to coding, compliance, and documentation requirements. Providing feedback to the Coding Manager and Group Lead as to any trends or issues discovered.
• Other duties as assigned.

Education: H.S. Diploma or G.E.D.

Experience: 1-2 years of coding/auditing experience required. Billing and collections experience in a healthcare setting is desirable. Prior experience in a medical practice setting or central billing office is desirable.

Knowledge:

• Payer Policies
• CPT, ICD-10, HCPCs
• Compliance
  • Proper documentation and reporting guidelines for CPT, ICD10, and HCPCs.

Skills:

• Motivated & Hard working
• Embraces constructive criticism
• Peer first mentality
• Maintains a strong desire to learn
• Highly accountable

Licenses/Certifications: Preferred: CPC

Working Conditions: Office environment. Use of computer, copier, Fax, telephone.

Physical Demands: Lifting/carrying___ Walking___ Sitting__X__ Standing____

Hearing___ Vision___ Bending___ Stooping ___Reaching ___ Other____