Coding Specialist

Tricore Reference Laboratories • Albuquerque, NM

430d

About The Position

The Coding Specialist at TriCore Reference Laboratories is responsible for overseeing the coding process, managing patient accounts, and ensuring proper reimbursement from payors. This role involves assigning appropriate ICD-10 codes and modifiers to laboratory tests, maintaining documentation, and implementing operating procedures to ensure timely claims submission. The specialist will also identify enhancements to the billing process and perform reviews for coding documentation and compliance.

Requirements

• High school diploma or GED required.
• Minimum of 1 year of healthcare coding experience or 12 months as a Coding Specialist Apprentice.
• Current Coding Certification from a Nationally Accredited organization (AAPC, AHIMA, NHA, or similar) required.
• Experience in medical billing and reimbursement is required.
• Knowledge of medical terminology, ICD-10 CM, CPT, and HCPCS is required.

Responsibilities

• Monitor the overall coding process and patient accounts management.
• Assign ICD-10 codes and appropriate modifiers to laboratory tests based on supporting documentation.
• Provide documentation and implementation of operating procedures for timely claims submission.
• Ensure timely data entry of corrected coding and notations to patient and client accounts.
• Identify enhancements to the overall billing process to meet performance metrics.
• Perform reviews for coding documentation and identify diagnosis trends.
• Capture Correct Coding Initiative (CCI) edits, modifiers, and payor requirements.
• Validate missing or invalid requisition information and address billing issues affecting reimbursement.
• Make corrections based on established departmental guidelines.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED