Thoroughly review medical records to code accurately the conditions or diagnoses that were treated or affected by the patient's plan of care. Verify that each reviewed medical record contains appropriate documentation to justify selected CPT, HCPCS, modifiers, and ICD-10 codes. Work with the Physician Billing Office and physician practices to improve code assignment, resolve and prevent edits, and review documentation deficiencies. Help educate and develop professional coding within the CFV Medical Group and Physician Business Office.
Key responsibilities include working closely with ambulatory practices and the Physician Revenue Cycle/Business Office to ensure accurate CPT, ICD-10, and modifier usage on claims; reducing coding-related denials and improving coding edits; reviewing documentation to support claim corrections and adjustments; assessing NCCI and CCI edits and applying appropriate modifiers; creating job aids and educational materials to identify revenue opportunities; providing education and feedback to providers, coding staff, and billing staff; analyzing provider coding profiles and documentation patterns; supporting the development of professional coders and coding standards; coordinating with Revenue Integrity to identify documentation gaps and revenue opportunities; and communicating problem issues that affect job performance.
Minimum Qualifications
- High school diploma or equivalent required
- Certified Coding Specialist (CCS) credential required
- Obtain Certified Professional Coder (CPC) or equivalent credential such as CCS-P within 1 year of employment
- 1 year of ICD-10 and CPT-4 coding experience in a hospital setting required
- 2 years of professional revenue cycle experience required
- 1 year of experience in a Business Office, physician practice, or professional coding environment preferred
Knowledge, Skills, and Abilities
- Proficiency in reading, writing, and speaking English
- Knowledge of ICD-10-CM/PCS and CPT-4 coding
- Knowledge of anatomy and physiology, medical terminology, and medical specialties needed to code accurately
- Ability to communicate tactfully with physicians and other personnel
- Ability to coordinate staff training and continuing education
- Ability to work independently and solve problems
- Excellent written and verbal communication skills
- Knowledge of medical necessity guidelines and their impact on coding accuracy and reimbursement
- Computer literacy
- Ability to sit for long periods
Location
North Carolina, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
4 weeks ago