Service Line Coding & Reimbursement Specialist (Hybrid), Day Shift, Patient Financial Services

Adventist HealthCare•Gaithersburg, MD

5d•$27 - $39•Hybrid

About The Position

Adventist HealthCare seeks to hire an experienced Service Line Coding & Reimbursement Specialist for our Patient Financial Services department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing. As a Service Line Coding & Reimbursement Specialist, you will: Evaluates initial CPT code selections made by providers for services rendered and takes steps to make necessary corrections. Ensure proper use of modifiers and other coding guidelines to prevent billing errors. Reviews medical records for accuracy and promptly reports incomplete documentation. Audits and corrects previously coded claims to ensure accuracy. Demonstrates knowledge and experience with CCI edits, payer edits, and payer policies, including Medicare NCD and LCDs. Serves as the main contact for coding inquiries, issues, and projects. Meets daily coding production and quality standards set by the manager/director. Contact the payer when necessary to troubleshoot inappropriate payer responses. Complete assigned work projects distributed by management in a timely manner. Provide documentation, data, and reporting to Senior Management and offer suggestions for process improvement. Provides updates to management on payer-related impediments to successful results. Audit balances for accuracy. Update patient demographic information and initiate account adjustments.

Requirements

High School Diploma required, or some college preferred.
Certified Medical Coder. Certified Radiology coder preferred.
Current certification in medical coding from the American Academy of Professional Coders (CPC), the American Health Information Management Association (CCS), or the Practice Management Institute (CMC).
5 years’ experience required within a healthcare environment to include physician practice, Revenue Cycle Company with multi-specialty responsibility.
Prior experience working as a certified coder.
Ability to work independently and in a team environment.
Strong verbal and written communication skills. Relating coding information in layman’s terms to providers and colleagues within the revenue cycle.
Good interpersonal skills to work across functional teams.
Must maintain a high volume of processing without compromising quality and accuracy.
Strong Customer Service skills.
Ability to participate in an environment that promotes staff development, productivity, satisfaction, and efficiency.

Responsibilities

Evaluates initial CPT code selections made by providers for services rendered and takes steps to make necessary corrections.
Ensure proper use of modifiers and other coding guidelines to prevent billing errors.
Reviews medical records for accuracy and promptly reports incomplete documentation.
Audits and corrects previously coded claims to ensure accuracy.
Demonstrates knowledge and experience with CCI edits, payer edits, and payer policies, including Medicare NCD and LCDs.
Serves as the main contact for coding inquiries, issues, and projects.
Meets daily coding production and quality standards set by the manager/director.
Contact the payer when necessary to troubleshoot inappropriate payer responses.
Complete assigned work projects distributed by management in a timely manner.
Provide documentation, data, and reporting to Senior Management and offer suggestions for process improvement.
Provides updates to management on payer-related impediments to successful results.
Audit balances for accuracy.
Update patient demographic information and initiate account adjustments.

Benefits

Work life balance through nonrotating shifts
Recognition and rewards for professional expertise
Free Employee parking
Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire
Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available)
Paid Time Off
Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period
Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance
Subsidized childcare at participating childcare centers
Tuition Reimbursement
Employee Assistance Program (EAP) support