Pro Fee Coding Specialist

Saint Francis Health System•Remote - OK, OK

5d•Remote

About The Position

The Pro Fee Coding Specialist reviews medical record documentation and reviews, adds, or corrects diagnosis and procedure codes submitted by providers. The specialist applies coding knowledge and valid coding resources to make coding decisions, support accurate claim submission, and help resolve coding-related denials. The role works with providers, office staff, billing personnel, quality and compliance teams, and coding resources, and involves direct interaction with patients and/or customers by telephone or face to face. The position is part time and day shift. The listed location is a virtual office in Oklahoma.

Requirements

High school diploma or GED.
Obtain one of the required certifications within one year of hire if not already certified: CCS, CPC, BCHH-C, RHIA, RHIT, or HCCS.
Sound understanding of medical-record content to locate information supporting coding or providing specificity.
Basic encoder skills.
Knowledge of Microsoft 365 and other applicable software.
Excellent written and verbal communication skills, presenting clear and concise information.
Effective interpersonal, organizational, and multitasking skills.
Ability to determine whether a record has sufficient documentation for coding or should be held for more documentation.
Ability to be cooperative, dependable, and responsive to changing coding workflows.
Ability to work independently and collaboratively in a fast-paced environment while managing competing priorities and deadlines.
Independent judgment in planning the sequence of operations and making minor decisions in a complex technical or professional field.

Nice To Haves

Experience and/or training in human anatomy and physiology and disease processes relevant to understanding the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded.
Two years of related experience.

Responsibilities

Code assigned records based on review of medical record documentation.
Apply current coding and billing requirements to ensure claims are submitted correctly.
Monitor coding and billing performance and resolve denials related to coding errors.
Review charge corrections and rebilling as needed to resolve coding denials.
Analyze claims denial data, develop preventative measures, and prepare periodic reports for clinical staff that identify corrective measures.
Advise and instruct providers on documentation and billing policies, procedures, and regulations.
Contact providers about conflicting, ambiguous, or nonspecific documentation and obtain clarification.
Educate providers and office staff about documentation, coding, billing changes, and regulations to support compliance with local, state, and national policies.
Collaborate with providers, office staff, billing personnel, quality and compliance departments, and coding resources to support accurate coding.
Stay current on coding rules by attending seminars and reviewing coding periodicals.