Charge Coding Analyst (Physician Offices), full time, hybrid

Holland Hospital•Holland, MI

3d•$23 - $35•Hybrid

About The Position

Applies and audits charges against medical record documentation. Enters and/or reviews all procedures prior to creating claims. Applies appropriate ICD codes, modifiers, and other related data to appropriately reflect the correct level of care and reimbursement based on documentation from the provider. Utilizes coding knowledge when adding procedures, diagnoses, and modifiers. Verifies that all services are coded, even across disciplines and service lines. You must live in the state of Michigan and be able to be onsite.

Requirements

High school diploma/GED, or higher education
Must live in the state of Michigan
Must be able to be onsite

Nice To Haves

Certified Coding Specialist (C-CCS)
Proficient in all aspects of medical coding of physician services, ambulatory, outpatient and ancillary services.
Proficient in CPT-4, ICD-CD, HCPCS, and modifiers.
Knowledge of Correct Coding Initiative (CCI) edits for bundled services.
Proficiency in eClinicalWorks and Cerner systems.

Responsibilities

Applies and audits charges against medical record documentation.
Enters and/or reviews all procedures prior to creating claims.
Applies appropriate ICD codes, modifiers, and other related data to appropriately reflect the correct level of care and reimbursement based on documentation from the provider.
Utilizes coding knowledge when adding procedures, diagnoses, and modifiers.
Verifies that all services are coded, even across disciplines and service lines.
Analyzes and validates records for deficiencies and queries the physician for additional information.
Assigns CPT-4, ICD-CD, HCPCS, and modifiers, as applicable based on the EHR documentation.
Reviews encounters/operative records to validate supporting documentation for medical necessity of the service.
Initiates and follows up on physician queries for additional information, when necessary.
Understands and utilizes the Correct Coding Initiative (CCI) edits for bundled services.
Sequences diagnoses and procedures according to coding guidelines.
Communicates any discrepancies or coding concerns with supervisor immediately.
Works with office manager and practice provider to capture all charges and identify opportunities for documentation and process improvement.
Works with necessary staff to help develop efficient processes to validate documentation for medical necessity of the service and to accurately assign the codes for billing.
Communicates opportunities and inefficiencies in a timely and professional manner to appropriate staff.
Conducts research, participates in discussions for process improvements; stays solution focused.
Maintains direct communication with provider in consistent manner.
Works with provider to clarify questionable documentation in a timely manner.
Facilitates personal education of changing regulations and communicates with providers regarding audit results and coding trends.
Participates in research of new services or charges and coding requirements of such.
Participates in external audit process and communicates with provider the results.
Stays current regarding CPT-4, ICD-CM, HCPCS code changes.
Collaborates with Revenue Cycle team regarding the professional fee schedule changes, and other items as needed.
Actively participates in team meetings and education of providers and staff as needed and assists with implementation of changes.
Attends educational opportunities by clinical staff and others to stay current on clinical aspects of care, current technology, charge capture issues and compliant coding and charging.
Effectively uses technology to capture claim data.
Navigates efficiently within the practice management system.
Maintains a thorough knowledge of the various computer systems and programs.
Maintains a high level of proficiency in the coding guidelines, policies and procedures for the various payers.
Utilizes the practice management system efficiently and accurately updates and edits information in eClinicalWorks.
Efficiently captures and verifies medical documentation (Cerner and eClinicalWorks) for appropriate coding and billing of claims.