Coding Specialist

Family Health Centers of Southwest Florida Inc•Fort Myers, FL

10d

About The Position

The Coding Specialist is responsible for accurately and efficiently coding FHC medical records in compliance with legal regulations and accepted standards. The specialist reviews assigned charts, checks for errors and omissions, makes necessary edits, and submits records for processing. The role also supports accurate reimbursement and reporting, regulatory compliance, and improved provider documentation practices.

Requirements

Demonstrated knowledge of Medicaid, Medicare, and commercial insurance rules and procedures in a managed care plan environment.
Knowledge of medical terminology and CPT, HCPCS, and ICD-10 coding and modifier usage.
Understanding of and adherence to HIPAA guidelines.
At least 1 year of employment in a healthcare-related field.

Nice To Haves

Completion of a Medical Coding & Billing course.
2 years of medical coding experience.
Certified Professional Coder (CPC) certification.
Understanding of FQHC billing procedures and Sliding Fee Schedules.

Responsibilities

Review accounts and abstract patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
Audit clinical documentation and coded data to confirm that documentation supports diagnoses, procedures, and services rendered for reimbursement and reporting.
Identify diagnostic and procedural information and review physician pending charges for appropriate complexity using CPT coding guidelines.
Assign codes for reimbursement and regulatory compliance using current coding conventions.
Work with the Coding Supervisor to provide providers feedback that improves documentation practices.
Confirm patient demographic, insurance, and referring physician information is accurately entered in Intergy.
Enter CPT, HCPCS, and ICD-10 codes and modifiers in Intergy accurately and on time.
Follow established checks and balances to ensure complete and accurate code capture.
Review Medicare Local Coverage Determinations (LCDs), Medicare bulletin updates, and Medicare NCCI.
Serve as a coding consultant to providers.
Keep current with compliance regulations, standards, and directives from governmental and regulatory agencies and third-party payers.
Keep current with coding guidelines, including Medicare, Medicaid, Managed Care, HEDIS, and FQHC guidelines.
Provide management with weekly updates and status reports.
Perform other duties as assigned.