Coding Specialist - 3147/Remote
About The Position
Wilmington Health is seeking a Coding Specialist to provide guidance and instruction regarding insurance coding protocol to ensure compliance with regulatory requirements. This role serves as a technical resource for all coding and billing regulations for provider services, assists in formulating policies and procedures, and interacts with medical and clinic staff to ensure quality and consistency. The specialist will perform quality control reviews, identify and address coding/billing issues, and educate staff. Responsibilities also include updating the clinic fee schedule and encounter forms annually, and performing monthly Evaluation and Management (E/M) profiling.
Requirements
- High school diploma or equivalency
- 3-5 years health insurance experience
- Certified Coder
- CPC, CCS-P
Nice To Haves
- Abstract coding experience
Responsibilities
- Serve as a technical resource for all coding and billing regulations for provider services
- Assist in formulating policies and procedures regarding coding and billing to ensure consistency and compliance across all clinic departments
- Interact with medical staff and clinic staff to ensure quality and consistency with coding and billing policies
- Perform quality control reviews of internal audits
- Work with designated clinic administrative staff in identifying and addressing significant coding/billing issues. This may include initiating policy changes and/or identifying areas in need of corrective action plans and assist in development and execution of actions plans
- Educating and training of clinic staff and medical staff
- Review and update clinic fee schedule on an annual basis
- Review and update of encounter forms/charge tickets on an annual basis
- Perform Evaluation and Management (E/M) profiling on a monthly basis
- E/M audits monthly and review with physician
- Add new prices, make sure codes are updated annually; update ICD-9 file annually
- Update charge sheets annually and as needed
- Update Experior when patients re dismissed from practice or from individual physicians and talk to patients with questions
- Read monthly Medicare, Medicaid, and coding bulletins; update appropriate staff and physicians
- Be available to staff and providers for coding questions
- Special project audits--i.e., shared visit documentation, Medicare audit requests, patient complaint audits
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
