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Coding Specialist 2
US--Telecommuting
Job ID: 2025-33798 Type: Regular Full-Time # of Openings: 1 Category: Professional Telecommuting
Overview
Billing Review Review documentation of professional services in EPIC, obtain copies of chart notes, reports (i.e., admission/discharge records, patient medical records) and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services' (CMS) documentation of professional services and assign correct CPT, ICD-9-CM, and HCPCS codes. Utilizes ICD-9-CM, ICD-10, CPT codebook and Coding Clinic references to verify code specificity and follow ICD-9-CM Official Guidelines for Coding and Reporting and AMA Official Guidelines for CPT.Enter billing information into EPIC Resolute.Establish and maintain procedures and other controls necessary in carrying out all insurance billing activity. Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP). Coordinate all billing information and ensure that all information is complete and accurate. Resolve with providers, any issues or questions which are found prior to submission to UMG for processing. Coordinate with the Revenue Cycle staff for audit of problem areas. Perform audits for levels of service and diagnosis coding and provide feedback to Practice Manager and/or Revenue Cycle staff. Attend education meetings and training as appropriate Community Hospital Cards Process hospital cards by verifying information related to the provider, hospital, date of service, diagnosis codes, patient name, spelling, and date of birth and account numbers.Print out all demographic and insurance information on all new hospital patients and forward to UMG for processing.Charge entry of hospital cards for established patients.Perform follow-up on questions from UMG.Create and maintain audit system to ensure receipt of all billable services. Provider Support Serve as a resource to providers for a broad range of billing policy and procedure issues. Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and governmental agencies as well as attend training seminars to learn and understand changing medical terminology, new diseases, new treatments, new drugs, and experimental procedures used in clinics, hospitals, and research facilities in order to advise physicians of billing practice changes in CPT, ICD-9-CM, ICD-10, HCPCS and insure changes are implements to maximize revenue. Make recommendations and implement remedial actions for problems. Work Queues Manage the following work queue's daily to ensure timely filing of charges:Pending work queue, charge review work queue, charge router charge review work queueMaintain charge entry workflow and keep charge entry staff informed of changes in procedure to maintain consistency. Responsibilities
High School diploma or GED.Minimum two years of hospital or professional services (dependent on position) experience reviewing, abstracting, and coding medical records using ICD-10-CM and CPT coding;Certification in one of the following Coding certification from AAPC or AHIMA:Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA). Active AHIMA membership may be required for some positions. Certified Professional Coder (CPC) through the American Academy of Professional Coders; OR equivalent certification. Qualifications
At least 2 years in a medical oncology office setting. Knowledge of CPT Outpatient coding guidelines. CCI edits Equal employment opportunity, including veterans and individuals with disabilities.
