Certified Coding Specialist

Certified Coding Specialist

Department: Revenue Cycle
FLSA Classification: Non-Exempt
Reports to: Business Office Manager

Position Summary:

The Certified Coding Specialist is responsible for interpreting patient records, test results, and other documentation to determine the most appropriate codes to bill, while remaining in compliance with government and insurance regulations. Effective communication, both written and verbal, working under pressure, meeting deadlines, and making decisions using sound judgement are essential to this role.

Schedule: 1.0 FTE; 40 hours per week.

Essential Functions:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Reviews charges ordered by providers and compares with chart documentation in the EMR to ensure that CPT codes, HCPCS codes, modifiers, and ICD-10 codes are billed at the highest level of specificity.
• Audits for the medical record for any missing or erroneous services.
• Performs accurate charge entry of hospital, surgical center, and other external charges into the EMR for billing.
• Works directly with Providers, Medical Assistants, and Clinic Managers to resolve coding issues and associated problems.
• Develops and participates in educational activities, including meeting with providers to review provider learning opportunities.
• Maintains strict confidentiality and follows HIPAA compliance.
• Review coding related denials to resolve and maximize reimbursement.

Skills:

• Strong knowledge of current procedural CPT, HCPCS, and ICD-10 coding guidelines.
• Thorough knowledge of federal guidelines, general coding principles, and payor guidelines.
• Excellent time management and prioritization of tasks.
• Strong knowledge of medical terminology and anatomy and physiology, and a basic knowledge of clinical procedures, diseases, and injuries.
• Holds themselves to the highest standards of ethics, honesty, and transparency in everything they do.
• Exceptional communication, both verbal and written.

Competencies:

• Teamwork
• Communication
• Decision Making/Problem Solving
• Job Knowledge
• Dependability
• Productivity
• Caring
• Patient Focused
• Intentional
• Integrity

Supervisory Responsibilities:

This position does not have any supervisory responsibilities.

Work Environment:

This position will work in an office environment with a moderate noise level. This role utilizes standard office equipment such as computers, phones, copiers.

Physical Demands:

Reasonable accommodations may be made to enable individual with disabilities to perform the physical requirements of this position.

This position is primarily a sedentary role; however, this position requires communication over the phone and in-person, and the use of standard office equipment. May be required to lift up to 10 pounds.

Travel:
Minimal local travel may be needed for this position to meet with providers at clinic locations.

Education and Experience:

• Education:
  • High School Diploma or Equivalent: Required
  • Current Certified Professional Coder (CPC) Certification: Required
• Experience:
  • One-year experience working as a certified coder in a medical setting: Preferred One-year experience working in Epic EMR: Preferred

Other Duties:

This is not a comprehensive list of all duties, responsibilities, or activities that may be required for this position. Position requirements including duties, responsibilities, or activities may change at any time, with or without notice.

Sound Family Medicine is a smoke-free, drug-free workplace. All employment offers are conditioned upon acceptable pre-employment drug tests which include testing for the use of marijuana and nicotine. As part of our commitment to a healthy workplace, we require employees to obtain an annual flu immunization.