Coding Specialist

SCOPE/GENERAL PURPOSE OF JOB:

This position is responsible for providing medical coding auditing services to physician practices, billing companies and hospitals and other related entities with a concentration on coding audits of physician and hospital outpatient claims, and coding education.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Performs coding audits of physician and hospital outpatient services, either at the client’s location or remotely, per client preference and consistent with the scope of the contract.
  • Creates clear explanations of errors as well as authoritative guidance for coding recommendations for all projects.
  • Customize training materials to the client’s specific needs.
  • Maintains confidentially of all information related to patients, medical staff, finances and all other RCCS and client information.
  • Demonstrates thorough understanding and ability to research all aspects of coding, compliance, documentation and reimbursement for assigned specialties.
  • Maintains accurate records of time spent on tasks for both client and non-client projects.
  • Adheres to all RCCS Corporate Policies and Procedures.
  • Assists with other duties as assigned.

EDUCATION AND/OR EXPERIENCE:

  • National certification in coding (AHIMA or AAPC) or health information management preferred.

SCOPE/GENERAL PURPOSE OF JOB:

  • Knowledge Areas:
    • Knowledge of coding, documentation and reimbursement.
    • Knowledge of organization policies and procedures.
    • Knowledge of health care administration principles.
  • Skills:
    • Knowledge of business office procedures.
    • Skill in identifying and resolving problems.
    • Ability to establish and maintain effective working relationships with all employees and clients.
    • Knowledge of CPT, ICD-10-CM and HCPCS coding related to Evaluation and Management, radiology, surgical and/or other specialty services.
    • Must be competent and comfortable with MS Word, Excel, and PowerPoint.

SUPERVISORY RESPONSIBILITIES: No

PHYSICAL DEMANDS:

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position requires full range of body motion including manual and finger dexterity and eye-hand coordination. The position additionally requires standing/sitting for extensive periods of time. Occasional lifting and carrying items weighing up to forty (40) pounds may be required. Requires corrected vision and hearing to normal range.

WORK ENVIRONMENT:

The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed either in an office environment involving frequent interaction with staff, clients and the general public, or a secure dedicated location within the employee’s home.

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