Posted On: 09/03/2019
Reports to: Manager, Billing Office
FLSA Classification: Non-Exempt
The coding specialist performs highly technical and specialized functions at Dickson Medical Associates. The employee reviews, analyzes, and codes diagnostic and procedural information that support Medicare, Medicaid, and private insurance reimbursement. The primary function of this position is to perform ICD 10 CM, CPT, and HCPCS coding for reimbursement for various medical specialties within the organization. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and guidelines. Communicates with Providers and staff. Participates in a team environment to include open communication, trust, accountability and mutual respect.
Responsibilities include but are not limited to:
Abstracts all necessary information and assigns proper billing codes (ICD-10, CPT, & HCPCS), which most accurately describe each documented diagnosis, surgical procedure, and special therapy or procedure according to established guidelines.
- Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct CPT code.
- Communication with providers and staff to encourage appropriate coding and documentation practices
- Serves as a resource and works with other business and clinical employees to resolve coding issues and questions.
- Consistently stays up to date with coding changes and mandates, communicating as appropriate to other staff members, including providers
- Performs any necessary coding-related training for staff and providers
- Performs other duties as assigned.
- CPC or related certification is required. Expectation of continuing education to maintain certification is required.
- Minimum of one to three years of physician practice coding experience required.
- High school diploma or equivalent, some college preferred (or applicable work experience).
- Experience with multi-specialty coding is a plus.
- Experience with NextGen is a plus.
- Sound judgment and problem-solving skills
- Customer-focused attitude, with high level of professionalism and discretion
- Familiarity with MS Office suite
- Excellent communication skills
- Skill in exercising a high degree of initiative, judgment, discretion, and decision-making to achieve organizational objectives.
- Skill in analyzing situations accurately and taking effective action.
- Skill in establishing and maintaining effective working relationships with providers, employees, patients, and the public.
- Skill in organizing work, making assignments, and achieving goals and objectives.
- Skill in exercising judgment and discretion in developing, applying, interpreting, and coordinating departmental policies and procedures.
- Skill in providing excellent customer service and patient services philosophy in all interactions.
- Skill in excellent organizational, time management and multi-tasking with attention to detail, as well as stay on task and concentrate with constant interruptions.
- Ability to assume responsibility and exercise authority over assigned work functions.
- Ability to establish and maintain quality control standards.
- Ability to organize and integrate organizational priorities and deadlines.
- Ability to investigate and analyze information, draw conclusions and problem solve.
- Ability to communicate on various levels to include management, customer and associate levels, both orally and in writing
- Ability to work and act independently, and to make and carry out decisions with minimal supervision.
Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.