Coding Specialist (ED/EM)

Overview

• The Coding Specialist is responsible for reviewing documents to identify all procedures and diagnosis.  The Coding Specialist must ensure the encounters have been coded correctly based on documents received.  The Coding Specialist must ensure encounters are coded using the most current coding guidelines.  The Coding Specialist should be able to communicate and recognize inadequate or incorrect documentation so that all coding is completed compliantly.

Responsibilities

• Performs ongoing analysis of medical record documentation and codes assigned per CMS, CPT, and Ventra Health documentation guidelines.
• Assign appropriate ICD-10-CM and CPT codes and modifiers according to documentation.
• Perform MIPS review as needed.
• Perform Provider QA as needed.
• Document coding errors.
• Assist coding management.
• Assist with client/provider audits as needed.
• Assist with reviewing work product of new coders in training, as needed.
• Provides feedback to coders on coding discrepancies/deficiencies, as needed.
• Provides feedback to coding manager on documentation deficiencies in a timely manner.
• Respond to questions from designated coders.
• Maintain confidentiality for all personal, financial, and medical information found in medical records per HIPAA guidelines and Ventra Health policy.

Qualifications

• High School diploma or equivalent.
• RHIT and/or CPC required.
• At least one (1) year of medical billing preferred.
• 2023 MDM Guidelines required.