Medical Coding Specialist
About The Position
The Medical Coding Specialist reviews medical records for compliance with coding and documentation requirements. The role performs prospective coding and documentation reviews for physician services, assigns appropriate ICD-10, CPT, and HCPCS codes, and enters charges in the practice management billing system while meeting departmental productivity and quality benchmarks. The specialist also reviews charge edits, seeks documentation clarification from physicians when appropriate, and participates in billing audits and compliance activities. The position is based on the Upper East Side in the Revenue Cycle unit and works Monday through Friday for 35 hours per week.
Requirements
- High school diploma.
- Approximately 2 years of experience in physician billing and CPT, ICD-10, and HCPCS coding.
- Prior experience working with an eMR system.
- Working knowledge of federal and state reimbursement regulations.
- Knowledge of third-party insurance billing policies and procedures.
- Ability to work in a highly organized, efficient, and reliable manner.
- Ability to handle job-related activities confidentially and in accordance with HIPAA.
- Ability to work independently and use sound judgment.
- Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint.
- Strong critical-thinking and problem-solving skills, including the ability to apply creative approaches to complex questions.
- Ability to multitask.
- Certified coder credential, such as CPC or CCS-P.
Responsibilities
- Perform ongoing prospective coding and documentation chart reviews for physician services to ensure coding supports the services billed.
- Identify issues and patterns related to coding.
- Select and assign appropriate ICD-10, CPT, and HCPCS codes based on chart documentation.
- Enter charges into the practice management billing system and meet departmental productivity and quality benchmarks.
- Perform charge-entry batch quality assurance.
- Review and resolve charge router and charge review edits as needed.
- Submit queries to physicians for documentation clarification, as appropriate.
- Participate in internal and external audits of billing operations and activities.
- Participate in mandatory compliance training and complete continuing education units required to maintain certification.
- Keep informed of changes in field policies and federal and state healthcare laws, regulations, and rules.
- Report deviations from institutional or departmental procedures.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
