Certified Coding Specialist (mainly Remote)

POSITION DESCRIPTION: Facilitates appropriate billing for inpatient, outpatient, ER and other complex specialty services by verifying determination of services provided, patient diagnosis''s via office and operative notes; enters correct charges into billing system; completes additional duties as required to ensure that billing and coding information is entered correctly and accurately. ESSENTIAL JOB FUNCTIONS: Verifies the surgeon''s determination of services provided and patient diagnoses via office and operative notes. Enters surgical charges in the billing system. Maintains complete knowledge and complies with all relevant insurance, CPT coding and diagnosis guidelines, disseminating info to staff and providers as necessary. Reviews quarterly provider audits, researching proper coding when necessary and working with coding and compliance as needed. Creates relationships with external organizations ( i.e. St. Joe''s and HVR ) that allow for streamlining and quick resolution of billing matters for patients. Documents conversations with insurance companies and patients. Audits hospital reports for surgical procedures with office billing to ensure accuracy of billing to insurance companies. Audits FIN sheets to verify correct insurance and demographic information. Communicates with hospital when appropriate. Attends regularly scheduled meetings. Coordinates and follows through with special projects as assigned. Performs other duties as assigned. ESSENTIAL QUALIFICATIONS: EDUCATION : High School Diploma or GED CREDENTIALS/LICENSURE : One of the following certifications: AAPC (CPC), PMIC (CMC), AHIMA (CCS-P). MINIMUM EXPERIENCE : 2 years'' surgical billing experience or other related background. POSITION REQUIREMENTS (ABILITIES & SKILLS): Familiarity with billing and managed care department basic services and hours of operation to respond to customer requests accurately. Knowledge of medical, including surgical, terminology and procedures at the level needed to perform job responsibilities, including understanding of CPT and ICD -9/ ICD -10 coding. Proficient/knowledgeable in the rules and regulations regarding insurance claim submission. Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, Microsoft Word, Excel, Outlook, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job. Excellent communication skills in both written and verbal forms, including proper phone etiquette. Ability to work collaboratively in a team-oriented environment; courteous and friendly demeanor. Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, patients, family members, insurance carriers, outside customers, vendors and couriers. Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations. Good organizational and time management skills to effectively juggle multiple priorities, time constraints and large volumes of work. Ability to exercise sound judgement and problem-solving skills, specifically as it relates to resolving billing and coding problems. Ability to handle patient and organizational information in a confidential manner. Ability to work under minimal supervision. Successful completion of IHA competency-based program within introductory and training period.

Created: 2021-11-29