Coding Specialist

ESSENTIAL FUNCTIONS

• Keep current with all coding systems used by InterMed including CPT-4 and ICD 9/10
• Work closely with departments to optimize coding, reduce denials, and ensure compliance with all coding rules and guidelines
• Provide consultative services to physicians and staff on complex coding issues and problem areas identified by internal or external coding audits.
• Train providers and staff to code services according to correct coding guidelines
• Performs periodic quality provider documentation and coding audits to review the accuracy of the codes assigned
• Adjust coding as necessary, completing supporting worksheets documenting rationale for coding decisions, comparing auditor findings against those generated from the provider, identifying and recording discrepancies, and recording the rationale for changes in coding decisions
• Analyzes audit data and provides summary feedback to individual clinicians, making recommendations for improvement
• Maintains current knowledge to ensure that InterMed’s coding and documentation meets regulatory guidelines and audit standards and results in appropriate reimbursements
• Maintains professional competency in professional services coding and documentation requirements
• Assist in the coding education process of providers and staff to ensure that billed services are properly coded based on CPT-4, ICD-9, HCPCS and ICD-10 guidelines.

JOB REQUIREMENTS

• Formal education as a coding professional or a bachelor degree in a health related discipline
• Certification as Certified Coding Specialist – Physician based (CCS-P), Certified Procedural Coder (CPC), Registered Health Information Administrator (RHIA), or Registered Health Information Technologist (RHIT)
• Three to five years of medical record coding experience required
• Three to five years of experience working/educating physician
• Three years of knowledge of compliance and regulatory requirements is required
• Experience with relative value systems and fee analysis
• Experience with computers including word processing, spreadsheet and graphing capabilities
• Extensive computer experience and ability to learn new computer applications quickly and independently, including: EMR(s), Microsoft Office Suite and other software programs
• Must be familiar with Medicare and Medicaid billing policies & procedures
• Thorough understanding data systems and reporting for health record coding, abstracting, and performance metrics
• Advanced understanding of medical terminology, pharmacology, body systems/anatomy, physiology and concepts of disease processes and the link to proper assignment of clinical conditions documented and procedures performed
• Proficient and in-depth knowledge of ICD-9-CM, CPT and HCPCS and Evaluation and Management coding guidelines
• Exemplary attention to detail and completeness with a thorough understanding of government rules and regulations and areas of scrutiny for potential areas of risk for fraud and abuse in regards to coding and documentation
• Excellent ability to conduct coding audits to evaluate quality performance measures and using the findings to create written reports with recommendations; and then present education and feedback to facilitate improvement of documentation and coding
• Excellent interpersonal communication skills (written and verbal) to deal effectively in delicate, sensitive and/or complex situations
• Excellent time management and project management skills
• Abides by the Standards of Ethical Coding as set for by AHIMA and AAPC
• Ability to work independently with minimal supervision is required
• Ability to work with and maintain confidentiality of physician, patient, patient account and personnel data is required
• InterMed, P.A. requires COVID-19 vaccination

SCHEDULE:

Monday through Friday, 40 hours per week