Ambulatory Coding Support Specialist I- Full Time Days

Cape Fear Valley Health

14d•Onsite

About The Position

Thoroughly review medical records to code specifically and accurately those conditions or diagnoses that were treated or affected the patient's plan of care. Verify that each medical record reviewed contains appropriate documentation to justify the selected CPT, HCPCS, modifiers and ICD-10 codes. Work with Physician Billing Office and physician practices to improve code assignment, resolve and prevent edits and review for documentation deficiencies. Help educate and develop professional coding within the CFV Medical Group and Physician Business Office.

Requirements

High school diploma or equivalent required
Certified Coding Specialist (CCS) credential required
Obtain Certified Professional Coder or other equivalent coding credential (such as CCS-P) within 1 year of employment required
1 year ICD-10 and CPT-4 coding experience in a hospital setting required
2 years professional revenue cycle experience required
Proficiency in reading, writing, and speaking the English language
Knowledge of ICD-10-CM/PCS and CPT 4 coding
Knowledge of anatomy and physiology, medical terminology and the various medical specialties as required to accurately code all different types of medical records
Use tact and diplomacy in all communications with physicians and other CFVH personnel
Ability to effectively coordinate staff training and continuing education
Ability to work well independently
Ability to problem solve
Excellent written and oral communication skills
Knowledge of medical necessity guidelines and recognition of the impact on coding accuracy and appropriate hospital reimbursement
Computer literate
Speech, sight and hearing required as incumbent must work independently in effectively training and monitoring coding functions
Long periods of sitting

Nice To Haves

1 year experience in Business Office, physician practice or professional coding environment preferred

Responsibilities

Work closely with CFV Medical Group/Ambulatory practices and Physician Revenue Cycle/Business Office to ensure CPT, ICD-10 and modifier usage is accurate on claims
Assist in overall goal to reduce coding related denials and improve coding related editing
Assist and advise Business Office on coding related denials by reviewing medical record documentation to make corrections and/or adjustments to claims as needed
Assess NCCI and CCI edits as necessary to apply appropriate modifiers and work closely with Business Office to improve front end editing as needed
Assist in identifying revenue opportunities within the Medical Group through the creation of Job Aids and instructional/educational materials
Provide education and feedback to providers, coding staff and billing staff as needed to ensure documentation requirements are maintained and revenue is optimized
Analyze providers’ coding profiles (E/M coding distribution) and documentation patterns to ensure that providers are confident with code selection and documentation requirements
Support the development of professional coders and coding standards within the Medical Group and Business Office
Coordinate with Revenue Integrity on identifying documentation gaps, potential revenue opportunities and support documentation improvement efforts overall
Make management team aware of problem issues, negative physician communication and/or other influences that impact effectiveness of job performance
Other duties as assigned