Coding Reimbursement Specialist II

Tryon Medical Partners • Charlotte, NC

9h

About The Position

Coding Reimbursement Specialist II Job Summary: The Coding Reimbursement Specialist II performs various duties to accurately interpret and bill physician charges for physician services by entering into the appropriate CPT, ICD-10, and modifiers into the Billing system. (This is a full-time position that will support the RCM team, Monday to Friday 8 am to 5 pm)

Requirements

• High school diploma or GED completion is required.
• A minimum of three (3) years’ experience with CPT and ICD-10 coding of physician services required.
• Coding certification required.
• Must maintain active certification and required CEUs during employment tenure.
• Advanced working knowledge of medical terminology, anatomy, and physiology required.
• Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers.
• Understanding of and familiarity with regulatory guidelines including NCDs and LCDs.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Advanced knowledge of the ICD-10 CM/PCS and CPT/HCPCS coding systems and conventions .
• Advanced knowledge of, but not limited to, Official Coding Guidelines and methodologies.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Good interpersonal skills and a basic understanding of team concept.
• Ability to gather and interpret clinical data.
• Ability to work independently in a fast-paced environment.

Nice To Haves

• CPC Certification preferred.
• Experience: Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, and Dermatology preferred.

Responsibilities

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services, according to guidelines established by the AMA.
• Enter appropriate data into the TMP billing system by selecting the appropriate codes, diagnosis, modifiers, to complete the charge process.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Contacts physicians through query protocols regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for TMP physicians' services.
• Performs other related duties as required and assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED