Pro Fee Coding Specialist

Saint Francis Hospital • New Haven, CT

210d

About The Position

The Pro Fee Coding Specialist performs diagnosis and/or procedural coding as assigned in order to apply the appropriate diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing.

Requirements

• Commensurate education with achieving qualifications to sit for Certification Exam(s) as related to ICD-10, CPT and other related specialty certifications.
• Certified Coder through AAPC, AHIMA, BCHH-C, HCCS for Home Health or National Healthcare Association.
• 0 - 2 years related experience including a demonstrated thorough understanding of the content of the medical record.
• Experience and/or training in the anatomy and physiology of the human body and disease processes.

Nice To Haves

• Basic computer and encoder skills.
• Effective interpersonal, oral and written communication skills.
• Ability to organize and prioritize work in an efficient and effective manner.
• Ability to maintain continuing education credits for credentialed coders.
• Ability to be cooperative, dependable and responsive to the changing nature of the coding workflow.

Responsibilities

• Codes as assigned from review of medical record documentation.
• Applies knowledge of current coding and billing requirements to assure claims are submitted correctly.
• Monitors coding and billing performance and resolves denials related to coding errors.
• Performs review for charge corrections and rebilling as required for resolution of coding denials.
• Develops preventative measures in response to patterns identified through analysis of claims denial data; prepares periodic reports for clinical staff, identifying corrective measures to resolve denial problems.
• Advises and instructs providers regarding documentation and billing policies, procedures and regulations; interacts with providers regarding conflicting, ambiguous or none-specific documentation, obtaining clarification of same.
• Educates providers and office staff regarding documentation coding and billing changes and regulations to assure compliance with local, state and national policies.
• Works collaboratively with providers, office staff, billing personnel, quality department and compliance, and coding resources to ensure accurate coding.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: No Education Listed