Medical Coding Specialist
Ensemble Health Partners
part-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $20 - $23 per hour
Job Level
About the role
- Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types
- The assigned codes must support the reason for the visit and the medical necessity that is documented by the provider to support the care provided
- When applicable, applies the appropriate charges such as the Evaluation & Management (E&M) level and injections and infusions and/or other necessary requirements for Observation cases, using third-party software systems such as LYNX
- Correctly abstracts required data per facility specifications
- Performs "medical necessity checks" for Medicare and other payers as required per payment guidelines
- Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis as a team, ensuring timely, compliant processing of outpatient claims in the billing system
- Maintains established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensures accuracy to maintain established quality standards
- Remains abreast of current requirements of the Centers for Medicare & Medicaid Services (CMS) to include National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through
- Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding (CAC) Medical Necessity software, abstracting system, code books, and all reference materials
- Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy
- Attends required system, hospital, and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs to ensure continued education and growth
Requirements
- 1 year of previous coding experience
- PC and Computer application knowledge and experience
- Navigational and basic functional expertise in Microsoft business software (Excel, Word, PowerPoint)
- Excellent organization skills, communication, time management, troubleshooting, and problem solving
- Ability to multi-task and prioritize needs to meet short- and long-term timelines
- Experience with EPIC and previous use of coding software tools
- Required Certifications: AAPC or AHIMA Coding Certification: CPC-A, CPC, CCA, or CCS
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-9-CM codingICD-10 codingCPT IV codingHCPCS codingmedical necessity checksdata abstractioncoding software toolsevaluation & management codingthird-party software systemsproductivity requirements
Soft Skills
organization skillscommunicationtime managementtroubleshootingproblem solvingmulti-taskingprioritization
Certifications
AAPC Coding CertificationAHIMA Coding CertificationCPC-ACPCCCACCS