Pro Fee Coding Specialist

Saint Francis Health System•Remote - OK, OK

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 role uses valid coding resources and coding knowledge to make decisions, support accurate claims, resolve coding-related denials, and help ensure compliance with applicable coding and billing requirements. The position works with providers, office staff, billing personnel, quality and compliance teams, and other coding resources. It is a full-time, Monday–Friday, dayshift position associated with Health Information Ambulatory Coding at the Yale Campus, with a listed location of Virtual Office, Oklahoma 73105.

Requirements

High school diploma or GED.
Hold one of the listed credentials: CCS, CPC, BCHH-C, RHIA, RHIT, or HCCS; applicants without a required certification must obtain one within one year of hire.
Sound knowledge of medical records and the ability to locate information that supports coding or provides specificity.
Basic encoder skills.
Knowledge of Microsoft 365 and other applicable software.
Excellent written and verbal communication skills, presenting information clearly and concisely.
Effective interpersonal, organizational, and multitasking skills.
Ability to determine whether a record has enough documentation to code or should be held for additional documentation.
Ability to be cooperative, dependable, and responsive to changing coding workflow.
Ability to work independently and collaboratively in a fast-paced environment while managing multiple priorities and competing deadlines.

Nice To Haves

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

Responsibilities

Code assigned cases based on review of medical record documentation.
Apply current coding and billing requirements to help 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 patterns and develop preventative measures; prepare periodic reports for clinical staff identifying corrective measures.
Advise and instruct providers regarding documentation and billing policies, procedures, and regulations.
Work with providers to clarify conflicting, ambiguous, or nonspecific documentation.
Educate providers and office staff about documentation, coding, and 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 ensure accurate coding.
Stay current on coding rules by attending seminars and reviewing coding periodicals.