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Provider Coding Specialist – Orthopedic

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteMid LevelTeam 1,001-5,000H1B No SponsorCompany Site LinkedIn

Location

South Carolina

Posted

97 days ago

Salary

Not specified

Seniority

Mid Level

High School2 yrs expEnglish

Job Description

• Analyze medical records, interprets documentation, and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD 10 CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), and modifiers utilizing designated software, coding manuals and other reference material as required • Enter charges for procedures that are not soft coded as instructed for certain patient types • Consistently meet coding quality and productivity standards established by the coding department • Work closely with Patient Financial Service (PFS) to review documentation and serve as department expert on coding questions. • Assist with coding inquiries from billing and administrative staff, ensuring that accurate codes are applied for appropriate reimbursement • Gather and verify all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract • Review and resolve clearinghouse rejection errors, denials, and charge review/claim edits daily. Also reviews accounts returned from various departments and processes corrections for clean claim submission • Collaborate with the Compliance/Quality Team when alerted to coding quality issues found via internal or external reviews; implement with accuracy coding quality recommendations • Work with HIM operations as needed to clarify queries and documentation needs for the completion of the medical record. • Query providers for clarification on incomplete or ambiguous documentation and follow up to ensure timely resolution • Review and code Orthopedic, OB/GYN, and other surgical specialties procedures with minimal supervision, ensuring correct coding and sequencing of diagnoses and procedures • Provide continuous education and feedback to surgeons and clinical staff regarding ICD-10 coding and documentation best practices for surgical procedures.

Job Requirements

High School Diploma Required
2+ years of abstract coding for physician services Required
Minimum of four years of healthcare experience, with at least three years of professional coding experience in Orthopedics or OB/GYN Required
Experience working remotely Preferred
Basic knowledge of ICD 10-CM diagnostic and CPT/HCPCS procedure codes principles and guidelines
Basic knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and metric systems
Basic knowledge of Standards of Ethical Coding
Skills and ability to communicate effectively both orally and in writing
Skills and ability to maintain working relationships with physicians and other staff
Skills and ability to review the work of others and maintain confidentiality
Knowledge of Microsoft Applications including (Excel, Word, PowerPoint, Outlook, etc)
Strong analytical capabilities
Strong organizational skills
Advanced ability to function independently and be a self-starter
Outstanding research skills and ability to use independent judgment to solve problems
Handle multiple priorities
Listen and acknowledge ideas and expressions of others attentively
Converse clearly using appropriate verbal and body language
Collaborate with others to achieve a common goal through cooperation
Influence others for positive and productive outcomes
Review medical record documentation and ensure accurate diagnosis and procedure code assignment to patient records
Expertise in assigning accurate CPT®, HCPCS Level II, and ICD-10-CM medical codes and modifiers based on coding and payer guidelines.
Maintain a solid understanding of anatomy, physiology, and medical terminology as required to accurately code provider services and diagnoses.