Health Information and Coding Specialist II

Millennium Physician Group•Fort Myers, FL

About The Position

The medical coder provides quality assurance of front-end activities of physician billing for primary care, specialists and ancillary services including coding and billing capture. S/he is responsible for inputting the appropriate code of various medical services so that healthcare practitioners and providers can receive payment for services rendered. S/he assigns and identifies the information by using the accurate ICD-10-CM and CPT codes. S/he is responsible for making sure the assigned codes meet all federal, legal and insurance regulations so service payments are obtained in a timely fashion. S/he responds to coding inquiries as needed. S/he provides post-submission reviews to assist in denial management and timely resubmission of corrected claims or appeals in conjunction with the Reimbursement Resource Representatives.

Requirements

Associate's degree or equivalent from two-year college or technical school.
1+ years clinical and/or Medicare Risk Adjustment experience.
1+ years of quality improvement experience, or other relevant experience preferred.
Experience working in health care and insurance industry.
Knowledge base of clinical standards of care, preventive health standards and office based procedures.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Ability to write routine reports and correspondence.
Ability to speak effectively before groups of customers or employees of organization.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.
Ability to apply concepts of basic algebra and geometry.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Proficient knowledge of Microsoft Excel Spreadsheet software; Microsoft Word Processing software, Outlook
Knowledge of Computers, Fax, Portals, Uploading, Downloading, Athena or other Electronic Medical Record System.
Certified Coder; CPC

Responsibilities

No coding errors
Understands ICD-10-CM and CPT codes
Verifies DX and treatment entries are complete and accurate
Queries physicians or support staff when codes are incorrect
Knows all changes in coding guidelines
Uses auditing tools to monitor accuracy
Actively communicates annual code updates, trends, concerns, carrier updates to leadership to ensure timely responses and actions.
Identifies trends that require action
Meets required productivity benchmarks based on assignment
Maintains active professional certification and complies with all educational, professional and ethical requirements of said certification