Coding Specialist

Responsible for assisting with oversight of the coding department, auditing to ensure quality and compliance, denial management, and production of coding/charge capture.

· Point of contact person for all coding related questions.

· Assists the department director with maintaining productivity standards of the coding department.

· Run and monitor reports, including Hold Report, DNFB Report, etc. to ensure coding turn-around time goals are consistently met.

· Works closely with coding staff to ensure timely completion of all coding related duties such as assignment of CPT, ICD-9 CM, and HCPCS level II codes, complete and proper charge capture, and follow up for any areas holding up the completion of coding related duties.

· Member of the Denial Management Task Force and is point of contact for denial questions from the Billing Specialists and PFS Clerks.

· Assists the department director with development implementation, and performance of coding compliance audits.

· Assists the department director in identifying educational needs for coding staff, billing staff, and providers.

· Responsible for assigning appropriate ICD-9 CM and ICD-10CM diagnoses, and CPT-4 codes for services provided in the inpatient an outpatient hospital setting.

· Evaluates provider and nursing documentation to ensure adequacy to support charges and for proper code assignment.

· Data entry of all charges not autogenerated by EHR.

· Evaluation, with corrections as needed, of all autogenerated charges to ensure these are supported by appropriate documentation.

· Knowledge of, application of, and/or compliance with all billing and coding edits.

· Knowledge of LCD and NCD guidelines to ensure compliance with these and to provide education to departments that are affected by them.

· Required to participate in mandatory training on EHR and UKG (time & attendance) and demonstrate basic competency in functions applicable to the role.

· Attendance required at Joint Manager monthly meetings and quarterly leadership training.

· Works under the direct supervision of the Revenue Cycle Director.

· Works closely with all clinic and hospital staff members.

· Position requires access to highly confidential information.

· Performs other duties as assigned.

· High school diploma or equivalent with computer skills required.

· Coding certification required and a minimum of 5 years’ healthcare industry experience in coding.

· Knowledge of billing preferred.

· Completion of medical terminology, anatomy and physiology courses required.

· Must be capable of handling multiple tasks quickly, calmly and professionally.

· Excellent organizational, communication and customer service skills necessary.

· Must be able to speak and write articulately.