Senior Coding - Reimbursement Specialist - Revenue Cycle

 

Atrium Health is seeking a highly skilled and experienced Senior Coding Reimbursement Specialist to join our dynamic team. This role is crucial in ensuring accurate and compliant coding and reimbursement for our healthcare services. If you are a seasoned professional with a deep understanding of medical coding, reimbursement methodologies, and regulatory requirements, we encourage you to apply.

About Atrium Health:

Atrium Health is a leading healthcare organization with a commitment to providing exceptional patient care. We offer a collaborative and supportive work environment where you can grow your career and make a meaningful impact.

 

Our Commitment to You:​

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Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:​

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Compensation​

Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training​

Premium pay such as shift, on call, and more based on a teammate's job​

Incentive pay for select positions​

Opportunity for annual increases based on performance​

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Benefits and more​

Paid Time Off programs​

Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability​

Flexible Spending Accounts for eligible health care and dependent care expenses​

Family benefits such as adoption assistance and paid parental leave​

Defined contribution retirement plans with employer match and other financial wellness programs​

Educational Assistance Program​

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Job Summary:

The Senior Coding Reimbursement Specialist is responsible for performing advanced coding and reimbursement functions, including auditing, education, and compliance oversight. This role requires a thorough understanding of ICD-10-CM, CPT, and HCPCS coding systems, as well as Medicare, Medicaid, and other payer guidelines. The specialist will work closely with physicians, nurses, and other healthcare professionals to ensure accurate and timely reimbursement.

Essential Functions
 

• Subject matter expert in multiple areas of coding, e.g., surgical coding (not including primary care procedures).
• Assigns CPT and ICD codes in cases of high complexity, judgment and scope.
• Reads, interprets and assigns CPT codes from provider documentation, e.g., operative report.
• Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered.
• Appends all modifiers.
• Ranks CPT codes when multiple codes apply.
• Assigns Evaluation and Management (E/M) codes.
• Performs reconciliation process to ensure all charges are captured.
• Processes automated or manually enters charges into applicable billing system.
• Researches and analyzes coding and payer specific issues.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Mentors teammates and coach providers on documentation improvement.

 

Physical Requirements
 

Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.

Education, Experience and Certifications
 

High School Diploma or GED required. Minimum of five years of coding experience required. CPC or equivalent coding credential required. Effectively communicates, either verbally or in writing, with providers related to coding issues that are of high complexity. Including face to face interaction, explaining coding rationales, and education with providers. Maintain coding certification (CPC, CCS, RHIT, RHIA). Extensive knowledge of coding, medical terminology, anatomy, and physiology. Extensive knowledge of and the ability to apply the payer specific rules regarding coding, bundling, and adding appropriate modifiers. In depth knowledge of claim editing rationale and revenue cycle. Basic knowledge of Relative Value Units. Understanding of and familiarity with regulatory guidelines including NCDs and LCDs. Excellent written and verbal communication skills.

 

 

Salary:  $26.10 - $39.15/hour

 

Accepting applications from candidates residing in these states:  AL, CO, FL, GA, ID, KS, KY, ME, MI, NC, SC, VA, VT

 

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