Coding Specialist

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

1d

About The Position

The Coding Specialist is responsible for accurate and efficient coding of FHC medical records in compliance with legal regulations and accepted standards. The position reviews assigned charts for errors and omissions, makes necessary edits, and submits records for processing. The Coder reviews and abstracts patient encounters, audits documentation and coded data, assigns codes for reimbursement and regulatory compliance, and works with providers and the Coding Supervisor to support accurate documentation and coding. The role also maintains accurate patient and insurance information in Intergy, monitors coding and compliance updates, and provides weekly status reports to management.

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.
• Understand and adhere to HIPAA guidelines.
• Minimum of 1 year of employment in a healthcare-related field.

Nice To Haves

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

Responsibilities

• Review and code patient accounts, abstracting diagnostic and procedural information, significant reportable elements, and complications.
• Audit clinical documentation and coded data to validate that diagnoses, procedures, and services rendered are supported 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 in accordance with current coding conventions and guidelines.
• Work with the Coding Supervisor to provide feedback to providers and improve 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 promptly.
• 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 weekly updates and status reports to management.
• Perform other duties as assigned.

Benefits

• Generous paid time off.
• Nine paid holidays.
• Excellent health benefits.
• Company-paid pension.
• Multiple bonuses.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed