Ambulatory Coding Support Specialist II- Full Time Days

Cape Fear Valley Health

6d•Onsite

About The Position

This role involves thoroughly reviewing medical records to accurately code conditions and diagnoses that were treated or affected the patient's plan of care. The specialist will verify that each medical record contains appropriate documentation to justify selected CPT, HCPCS, modifiers, and ICD-10 codes. The position also requires working with the Physician Billing Office and physician practices to improve code assignment, resolve and prevent edits, and review for documentation deficiencies. Additionally, the role supports educating and developing professional coding practices within the CFV Medical Group and Physician Business Office.

Requirements

Bachelor’s degree in health information management required OR 8 years’ coding experience in lieu of degree required
CPC, CPMA, RHIA, RHIT, CCS or CCS-P or other equivalent credentials required
Understanding of medical terminology, anatomy and physiology and familiarity with medical record content
In-depth knowledge of ICD-CM coding principles, LCDs/NCDs, HCCS and other coding conventions for professional documentation and claim submission
Uses tact and diplomacy in communications with physicians and other CFVH personnel
Excellent communication skills
High degree of interpretation, analysis, planning, coordination, and organization of information
Decisions require intense mental effort and consideration of reimbursement ramifications
Utilize past experiences, practices and organization to accomplish goals
Assign accurate codes using good judgment in a timely manner within broad guidelines
Must be flexible
Ability to concentrate in a busy, noisy, and crowded environment with demands and interruptions 75% of the time
Job requires computer literacy
Speech, sight and hearing required as incumbent must work independently in effectively training and monitoring coding functions
Long periods of sitting
Near visual acuity required
Motor coordination required to operate computer

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 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 supports 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