Coding Specialist - Full-time

Under direct supervision, performs all collection functions on account balances within assigned financial classes

Education

Specialized training in coding/abstracting procedures, anatomy and physiology and medical terminology obtained through seminars and college courses

Experience

One year of direct billing or collections experience required in a healthcare or insurance environment. Completion of medical billing and coding course and coding certification required. 1 year of CPT and ICD10 coding experience

Knowledge, Skills and Abilities

• Knowledge of collection procedures, laws, rules and regulations
• Skill in written and oral communications
• Skill in performing arithmetic calculations

Licensures, Certifications

Active AAPC certification required

Additional coding certifications applicable to physician practice billing preferred

Principal Duties and Responsibilities

• Works with front-desk staff and practice managers to ensure accurate patient registration in the practice management system
• Reviews provider documentation for auditing purposes related to billing and communicates with providers when there are errors, missing information, or other inaccuracies
• Reviews physician charges, adds modifiers, diagnoses, or other standard coding conventions to ensure accurate and timely billing, making corrections as necessary.
• Creates and submits clean claims for billing by reviewing and correcting claim errors in accordance with established policies and procedures
• Stays up to date on payer billing requirements, as well as CMS, CPT, and AMA regulations
• Reviews and works open encounter, encounter missing charges, and inpatient note reconciliation reports
• Communicates with patients when there are questions related to their billing and coding
• Functions as the practice liaison with the Billing Office and assists in educating the practice staff about efficient and compliant billing and registration practices
• Works with AR staff to resolve/appeal denials
• Works closely with Providers, offering assistance and education regarding correct CPT and ICD 10 coding as well as documentation requirements
• Manages time effectively and reviews a minimum of 12 charges sessions an hour
• Maintains coding certification through continuing education courses

Physical Requirements

• Ability to concentrate and pay close attention to detail
• Ability to sit for long periods of time

Working Conditions

• Normal office work environment

Conditions of Employment

N/A

All roles must demonstrate GBMC Values

GBMC Values

Value Description

Respect

I will treat everyone with courtesy. I will foster a healing environment.

• Treats others with fairness, kindness, and respect for personal dignity and privacy
• Listens and responds appropriately to others’ needs, feelings, and capabilities

Excellence

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

• Meets and/or exceeds customer expectations
• Actively pursues learning and self-development
• Pays attention to detail; follows through

Accountability

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time

Teamwork

I will be engaged and collaborative. I will keep people informed.

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive way
• Seeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others

Ethical Behavior

I will always act with honesty and integrity. I will protect the patient.

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

Results

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

• Embraces change and improvement in the work environment
• Continuously seeks to improve the quality of products/services
• Displays flexibility in dea