Medical Coding Specialist

Title: Medical Coding Specialist

Location: Upper East Side

Org Unit: Revenue Cycle

Work Days: Monday-Friday

Weekly Hours: 35.00

Exemption Status: Non-Exempt

Salary Range: $31.92 - $35.44

*As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices

Position Summary

Responsible for reviewing medical records for compliance with coding and documentation requirements.

Job Responsibilities

• Performs ongoing prospective coding and documentation chart reviews for physician services to ensure that the coding supports the services billed. Identifies issues and patterns related to coding.

• Selects and assigns the appropriate ICD-10, CPT and HCPCS codes, based on chart review documentation. Identifies issues and patterns related to coding.

• Enters charges into the practice management billing system, ensuring to meet productivity and quality-based departmental benchmarks. Performs charge entry batch quality assurance.

• Reviews and resolves charge router and charge review edits, as needed.

• Submits queries to physicians, as appropriate, for documentation clarification.

• Participates in internal and external audits of billing operations and activities.

• Participates in annual and on-going mandatory compliance training. Fulfills Continuing Education Units necessary to maintain certification status.

• Keeps informed of changes in policy within the field.

• Stays abreast with compliance on federal, state health care laws, regulations and rules. Reports any differentiation from institutional or departmental procedures.

Education

• High School Diploma

Experience

Approximately 2 years of experience in physician billing, CPT, ICD-10 and HCPCS Coding.

Prior experience working with an eMR system.

Working knowledge of federal and state reimbursement regulations.

Knowledge of third party insurance billing policies and procedures.

Knowledge, Skills and Abilities

• Ability to perform duties in a highly organized, efficient and reliable manner.

• Conducts job related activities in a highly confidential manner and in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

• Must be able to work independently and use sound judgment to execute assignments.

• Demonstrated proficiency in Microsoft Office Suite, including Word, Excel and PowerPoint.

• Strong critical thinking and problem solving skills with proven ability to apply creative approaches to complicated questions.

• Must be able to multi-task

Licenses and Certifications

• Certified coder (CPC, CCS-P)

Working Conditions/Physical Demands

Standard office work

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