Healthcare Specialist: Medical Coding Expert
2 days ago
As a key member of our organization, you will play a pivotal role in ensuring the accurate and timely submission of medical claims. Your expertise in medical coding and billing processes will optimize revenue cycles while maintaining compliance with regulatory standards.
This is an opportunity to make a significant impact on our organization's financial operations and the quality of service we provide to our clients.
- Analyze and abstract medical information from patient records for physician/NP visits and home health start-of-care visits.
- Accurately code diagnostic and procedural information in compliance with ICD-10, Home Health PDGM, CPT-4, HCPCS, MS-DRGs, APCs, and POAs, following national coding guidelines.
- Document essential patient information, including medication history, medical history, active diagnoses, and preventive care screens.
- Consult with medical providers to identify potential missing HCC diagnoses and ensure accurate documentation and code assignment.
- Review claims data to verify accurate coding and billing for all services and procedures.
- Collaborate with healthcare professionals to improve documentation, coding accuracy, and compliance.
- Stay current with changes in coding regulations and provide education and training as needed.
- Participate in Quality Assurance/Quality Improvement initiatives.
- Assist the Clinical Director in developing and achieving key performance indicators related to coding accuracy and compliance.
- Develop and maintain effective communication with clinical staff, insurance plans, and hospital systems.
- Assist with billing and credentialing tasks as needed.
- Maintain confidentiality and safeguard patient information.
- Background in a medical field.
- Proficient in the English language, both written and verbal.
- Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCS-P) from AAPC or AHIMA (preferred, not required).
- At least 2 years of experience in medical coding and billing, with a focus on physician and home health coding.
- Knowledge of medical terminology, anatomy, and physiology, as well as coding systems and guidelines (ICD-10, CPT-4, HCPCS).
- Strong analytical skills and attention to detail.
- Proficiency with coding software, tools, and EHR systems.
- Knowledge of regulatory requirements and compliance standards.
- Excellent communication skills and ability to collaborate with healthcare professionals.
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