Job Title: Medical Coding Specialist
Employment Type: Regular Full-time
Work Schedule: Monday-Friday, 8:30 am - 5:00 pm. Full on-site in office work, with potential to offer hybrid schedule.
Department: Compliance
Job Purpose: Under supervision, the Medical Coding Specialist evaluates medical records and encounter documentation to ensure completeness, accuracy, and compliance with the ICD-10 manual and the AMA’s CPT manual.
Key Responsibilities:
- Medical Coding: Review and analyze patient records and clinical documents to ensure completeness and accuracy for coding. Assign and sequence diagnostic and procedural codes using ICD-10-CM and CPT coding systems for all services rendered.
- Compliance and Accuracy: Adhere to coding guidelines and regulatory requirements, ensuring all coding is compliant with national standards and payer policies. Stay updated on the latest coding rules, regulations, and trends through continuous education and training.
- Collaboration with Healthcare Staff: Engage in regular discussions with medical providers to clarify missing, incomplete, or unclear information in medical reports. Provide ongoing feedback and education to clinical staff regarding best practices in documentation to facilitate accurate coding. Attend and participate in regular healthcare team meetings to stay informed about patient care and coding-related updates.
- Billing Support: Accurately translate medical procedures and diagnoses into codes that can be understood and utilized by payers, other medical coders, and medical facilities. Ensure timely transmission of coded patient treatment information to payers and other relevant parties for reimbursement purposes. Work closely with the billing department to coordinate insurance claims and patient billing, resolving any coding-related issues that may arise.
- Record Maintenance: Maintain strict confidentiality of patient information in accordance with HIPAA and other privacy laws. Ensure all medical records are coded accurately and stored securely, maintaining high standards of data integrity and confidentiality. Keep coding guidelines and procedure manuals current, incorporating any changes in coding practices or regulations.
- Professional Development: Actively pursuing opportunities for continuous learning and professional development to remain proficient in medical coding. Attend workshops, seminars, and training sessions to enhance coding skills and stay abreast of industry changes. Serve as a mentor and resource for newer or less experienced medical coders, sharing knowledge and best practices.
- Miscellaneous: Requires the ability to relate to people of diverse backgrounds, cultures, races, sexual orientations, and gender identities or expressions. Responsible for maintaining confidentiality of all patients, clients, proprietary, and protected information. Employees are accountable to meet performance standards of their departments. They participate in compliance audits and quality improvement plans. Assist in automation of cash receipt application. Other temporary duties as assigned.
Qualifications:
- Educational Background: Associate’s degree in health information management or a related field.
- Certification: Professional coding certification (e.g., CPC, CCS).
- Experience: 3-4 years of professional fee coding experience.
- Knowledge and Skills: Proficiency in Medical Terminology, ICD-10, CPT codes; understanding of FQHC billing regulations; strong attention to detail; effective communication skills.
- Ongoing Education: Commitment to continuous learning in coding guidelines and healthcare regulations.
Physical Requirements: While performing the duties of this job, the employee is required to stand, sit, walk, use hands to finger, handle, or feel; reach with hands and arms, talk and hear. Occasionally the employee must stoop, bend, and lift or move up to 25 lbs. Specific vision abilities required include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.
Equal Employment Opportunity: Trillium Health promotes Equal Employment Opportunity for all, respecting diverse backgrounds, cultures, races, ages, experiences, and opinions. Employees must meet department performance standards and participate in compliance audits, process improvement, and quality improvement plans.