Coding Reimbursement Specialist II - Revenue Cycle

Overview

Job Summary

Performs duties of mid to intermediate complexity. Applies CPT and ICD codes to ensure appropriate revenue generation and compliance with billing guidelines.

Essential Functions

• Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered.
• Appends all modifiers.
• Ranks CPT codes when multiple codes apply.
• Assigns Evaluation and Management (E/M) codes.
• Performs reconciliation process to ensure all charges are captured.
• Processes automated or manually enters charges into applicable billing system.
• Researches, answers, and processes all edits associated with claim and coding submission.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Communicates with providers related to coding issues that are of mid to intermediate complexity. Including face to face interaction and education with providers.
• Applies modifiers and appropriate ranking to encounters with multiple codes.

Physical Requirements

Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.

Education, Experience and Certifications

High School Diploma or GED required. Minimum of 1 year of coding experience required. CPC or equivalent coding credential required. Maintain coding certification (CPC, CCS, RHIT, RHIA). Working knowledge of coding, medical terminology, anatomy, and physiology. Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers Understanding of and familiarity with regulatory guidelines including NCDs and LCDs.