Reimbursement Coordinator - Corporate Reimbursement/Coding - Full Time

Guthrie Enterprise•Sayre, PA

About The Position

Position Summary: Responsible for reviewing clinical documentation to accurate assign CPT, ICD‐10, and modifiers. Responsible for coding multispecialty services including procedures, evaluation and management, ancillary procedures and works variance coding workqueues. Provide a high level of technical competency and serves as a subject matter expert regarding documentation guidelines, coding, and reimbursement. Works in collaboration with providers, operational managers, and CBO. Will coordinate, implement and support billing and coding processes.

Requirements

High School Diploma or equivalency required
Must have a proficient knowledge of Medicare, Medicaid, and other third party payer coding and billing regulations.
Must be able to demonstrate a strong knowledge of CPT, ICD‐10‐CM and HCPCS coding systems and guidelines, medical terminology, anatomy, and physiology.

Nice To Haves

Degree in Health Information Technology or possession of RHIA, RHIT, CCS or CPC certification desirable.
Recommend CPC Certification be obtained within 18 months of date of hire.

Responsibilities

Manually code provider services by reviewing clinical documentation to assign the appropriate CPT, ICD‐10, and modifiers.
Responsible for working coding edits to assign appropriate codes within coding edits daily to ensure appropriate and timely capture of revenue.
Perform clinical and coding reimbursement assessments to ensure revenue capture. Make recommendations to appropriate providers, staff, and leadership partners.
Communicate with all parties involved the results of quality coding/documentation reviews.
Maintains working knowledge of payor regulations and third‐party guidelines.
Perform special audits upon request to analyze billing activity.
Ensure all regulations are met and claims subsequently submitted to payers accurately.
Contribute to maintain a team environment. Must work in a way that demonstrates and promotes teamwork.
Maintains confidentiality regarding patient accounting.
It is understood that this description is not intended to be all‐inclusive and that other duties may be assigned as necessary in the performance of this position.