Medical Coding Specialist

KVC Health Systems•Webster Groves, MO

2d•Onsite

About The Position

The Medical Coding Specialist is KVC’s Hospitals subject matter expert on medical coding. They are responsible for ensuring maximum billing opportunities for KVC Hospitals, Inc. They will conduct audits and code reviews on all documentation of medical providers to ensure accuracy and optimum billing recoupment is met for KVC Hospitals. This role will collaborate with the medical providers, Utilization Review Department, and Accounts Receivable Department to ensure all legal requirements regarding coding procedures and practices are met and billing can be maximized in the most time efficient manner. The Medical Coder will support and foster a culture that is focused on integration of utilization review, risk management, and quality assurance into management in order to ensure the judicious use of the facility's resources and high-quality care.

Requirements

Minimum of a high school diploma or equivalent from an accredited institution.
One of the following certifications is required: Certified Coding Associate Credential (CCA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Medical Coder (CMC), and Certified Inpatient Coder (CIC).
Valid driver’s license and auto insurance required.
Minimum of four (4) to seven (7) years of medical coding experience.
Experience working in hospital or healthcare field with specific role in medical coding.

Nice To Haves

Bachelor’s degree in Health/Hospital Administration, Business Administration or related human services field preferred.
Five (5) or more years related experience in behavioral health/psychiatric medical coding field.
Preferred medical coding certification prior to hire date.
Requires skills in Microsoft Office Suite, including Word, Excel, Outlook email and experience working within an Electronic Health Record.

Responsibilities

Practice conduct that displays respect for all KVC colleagues and community stakeholders regardless of age, gender identity, sexual orientation, race, religion, veteran status or ethnicity.
Serve as resource and subject matter expert to ensure correct medical coding.
Classifies medical/psychiatric data from patient records and is responsible for translating diagnostic and clinical information into the maximized billing alpha-numeric ICD-10 codes.
Provide training and education of medical providers and treatment team in the functions of coding and enhancement of current practices.
Ensure Utilization Review and billing services are following professional standards, state and federal regulatory requirements and licensing bodies.
Maintain current knowledge of KVC’s operating systems including, but not limited to, EHR and HRIS tools.
Maintain current knowledge of JIAC and KVC policies and procedures, KVC programs and services, and outside community agencies.
Completes all necessary tracking and reporting on statistical data for analysis utilization review data, including but not limited to tracking and reporting out trends, admission insurance breakdowns, daily reports, etc.
Ensures KVC Hospitals achieves clinical outcomes through fiscal accountability.
Maintains strictest confidentiality about patient and patient’s family information.
Collaborates with the Utilization Review Department and Accounts Receivable Department to monitor collection efforts and work to resolve disputes to expediate payment and reduce denials and bad debt levels.
Works on a multi-departmental team to ensure maximization of insurance recoupment through best practices in medical coding and to assist in successful achievement of KVC Hospitals’ fiscal goals.
Communicates effectively and respectfully both orally and in writing with internal staff and external payor sources; as well, uses strong active listening skills.
Participates in other internal committees as directed (Medical Management/Executive Committee, Performance Improvement (PI) Committee) and others as assigned.
Some day and overnight travel will be required to meet with KVC Hospitals treatment teams in other locations.