Provider Coding Specialist

Job Description

Description

PeaceHealth is seeking a Provider Coding Specialist for a Full Time, Day position.  Hourly compensation starts at $20.88, more depending on experience.

JOB SUMMARY

Responsible for ensuring accurate and consistent procedural/diagnostic coding and documentation, timely and complete charge capture, and correction/resolution of insurance claim denials and patient disputes due to coding issues.

ESSENTIAL FUNCTIONS

1. Processes billing system claim edits and reviews CPT/ICD-10 coding and medical record documentation submitted by providers for accuracy prior to billing.
2. Reviews claims denied due to coding issues and makes corrections/recommendations for corrections.
3. Assists providers and PFS billing/reimbursement staff with coding questions.
4. Researches coding/compliance issues utilizing regulatory and medical informational resources.
5. Collaborates with other coding staff to identify trends and issues with provider coding practices and edits, reviews monthly edit and denial reports to make recommendations for provider and staff education.
6. Assists in preparation and distribution of provider education materials and participates in provide/staff individual group education presentations regarding coding issues.
7. Participates in departmental and cross-regional meetings and projects involving coding/billing and helps develop forms/process for use in clinics.
8. Maintains communication and relationships with PFS billing and reimbursement management and staff regarding issues affecting coding and charge capture.
9. Performs other duties as assigned.

QUALIFICATIONS

EDUCATION:

• High school diploma or equivalent preferred.
• Knowledge of anatomy, physiology, medical terminology, diseases, procedures and therapies.

EXPERIENCE/TRAINING:

• Minimum of one year of experience in physician professional coding in a medical care facility, billing office or medical records department preferred.

LICENSE/CERTIFICATION:

• CPC (Certified Professional Coder); Certified Outpatient Coder (COC) or CCS-P (Certified Coding Specialist – Physician Based), RHIT or RHIA preferred. If not currently certified, must obtain within one year of employment.

OTHER SKILLS:

• Proficiency in coding Professional Inpatient and/or Ambulatory Care, Emergency Department and Outpatient medical records with ICD-10 CM and CPT4 classification systems with expertise in one or more specialty area.
• Proficient in the use of MS Office applications including Excel and Word.
• Adept and proficient in windows based computer environment with respect to coding software systems.
• Good verbal and written communication skills
• Critical thinking and problem solving skills required.
• Familiarity with medical billing software and electronic medical record preferred.

SHARED SERVICES PHYSICAL/COGNITIVE REQUIREMENTS:

• Work requires normal amounts of physical effort from up to 65% of the time.
• Ability to lift objects weighing 30 lbs. or less.
• Work is performed under normal working conditions with adequate lighting and ventilation. extended periods of sitting while reviewing records and entering clinical data into a computer monitor where noise level is moderate.
• Duties require the ability to concentrate or pay close attention to detail (more than 65% of work time).

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For full consideration of your skills and abilities, please attach a current resume with your application.  EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.