Medical Coding Specialist (Full-Time)

Job Description

Job Description

Job Title: Medical Coding Specialist (Full-Time)

Department: Billing

Reports to: Billing Supervisor

Employment Status: Non-Exempt

Supervisory Responsibilities: None, except when designated as a coding department team leader.

General Summary

Responsible for reviewing patient services into the electronic practice management and prepare Nextgen to generate claim for the insurance company and statement for self-pay patients. Generate various reports for end of month. The employee in this position may serve as a billing specialist if designated.

Essential Job Functions

• Translates patient information and places into numeric or alphanumeric medical codes.
• Reviews missing encounter reports and verifies patient visits.
• Reviews missing unsigned documentation and missing information reports.
• Enters and maintains ‘Patient Count’ Spreadsheet for providers on a daily basis showing how many patients were seen.
• Reviews and compare the Patient Count’ Spreadsheet at the end of each month along with the Encounters report.
• Reviews and maintains ‘Yearly Summary Report’ spreadsheet each month.
• Reviews and maintains monthly coding audits.
• Posts ‘Unapplied Amounts by Account’ from report if needed.
• Researches all charges in Nextgen.
• Review and educate staff on modifiers.
• Research any charges with missing information and/or not completed information to the Nursing Supervisor/s and/or clinicians.
• Research all EM codes to ensure all levels are correct according to the coding guidelines.
• Reviews and research all new and old ICD-10 codes, HCPCS codes and CPT codes.
• Share and educate all new coding information with staff.
• Share and update all information quarterly with clinical staff.
• Ensures the practice is properly coded for all procedures completed.
• Research and review any invalid procedure and/or diagnosis code rejections.
• Participates in educational activities (webinars) and attends monthly and yearly staff meetings.
• Other duties as assigned

Knowledge, Skills, and Abilities

• Knowledge of several different coding systems, including Level 1 HCPCS and Level 2 HCPCS
• Knowledge of ICD-10
• Ability to think analytically
• Skill in problem-solving
• Knowledge of various billing software and systems
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Ability to deal with problems involving several concrete variables in standardized situations.
• Able to work independently with minimal supervision.
• Knowledge of third party/commercial insurances
• Knowledge of Medicaid and Medicaid HMO insurance plans
• Knowledge of billing and collections principles
• Ability to explain patient benefit and eligibility information
• Skill in answering telephone calls on multi-line system
• Ability to interact with patients, families, and coworkers in a professional manner.
• ​Ability to multitask and work in a fast-paced environment
• Ability to practice excellent customer service, for external and internal customers
• Knowledge of office management principles, methods, and procedures to complete work assignments.
• Ability to prioritize tasks
• Ability to remain organized in the completion of assigned tasks
• Ability to be dependable (Being at work when scheduled, and on time)
• Ability to work under pressure
• Ability to maintain confidentiality according to HIPAA guidelines
• Ability to handle conflict in a professional manner
• Ability to perform basic clerical duties
• Ability to operate phones, fax machines, printers, copiers, etc.

Qualifications/Education and Experience

• High school diploma required
• College required
• Certification in Medical Coding preferred
• At least 4+ years related experience
• Healthcare billing experience required
• Proficient in speaking and writing English

Physical Requirements

• Seeing: Must be able to see well enough to read emails, documents, reports, etc.
• Hearing: Must be able to hear well enough to communicate with other staff, clients, vendors, etc.
• Standing/Walking: Must be able to move about the office, including up and down stairs
• Climbing/stooping/kneeling: Must be able to stoop or kneel to pick up small items, file documents, etc.
• Lifting/pulling/pushing: Minimal lifting required in this position
• Fingering/grasping/feeling: Must be able to type and use technical sources.

Working Conditions: Normal working conditions absent extreme factors

Note: The statements herein are intended to describe the general natures and level of work being performed but are not to be seen as a complete list of responsibilities, duties, and skills required of personnel so classified. Also, they do not establish a contract for employment and are subject to change at the discretion of the employer.

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