About Our Company

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

Job Description

Position Summary:

High level understanding and ability to review/abstract appropriate CPT-4, ICD-10-CM, HCPCS and modifiers for patient encounters and procedures. Must also exhibit an of understanding of AMA, specialty specific coding/billing/auditing concepts & compliance guidelines (CMS/OIG/Federal/State regulations) to perform daily functions. Daily use of various EMRs and other clinical, coding applications, along with Microsoft application (word, excel, outlook, etc.) is required. The Coding Specialist is expected to apply knowledge of anatomy and function as well as disease processes to CPT coding and ICD10CM coding. 

Essential Job Functions:

•             Monitoring and working work queues/dashboard for assigned providers and specialties, to include coding, researching, and trending of coding/billing behaviors.

•             Code all documented professional services provided in both clinic and other facilities

•             Applies CPT-4, ICD-10-CM, HCPCS and modifiers following coding guidelines

•             Adheres to official coding guidelines, AMA and CMS

•             Expert in reviewing assigned providers/specialty areas

•             Ensures coded services, provider charges and medical record documentation meet appropriate guidelines and standards

•             Keeps abreast of coding guidelines and reimbursement reporting requirements

•             Illustrate knowledge of healthcare industry in areas of coding, revenue cycle, claims and state specific insurance/laws

•             Ensure timely charge review/processing of daily submissions

•             Monthly review of reports to identify and abstract any missed charges in assigned specialties

•             Works collaboratively with Team to ensure monthly goals are met

•             Responsible for creating/updating reference tools for assigned specialties as needed (tip sheets/coding guidelines, etc.)

•             Utilize appropriate application/methods to ensure all documented professional services are submitted timely

•             Ability to identify/trend/summarize potential compliance, coding, billing concerns and bring forth a potential resolution

•             Other duties as assigned

Education, Certification, Computer and Training Requirements: 

•             High School Graduate/GED required. Associate’s or Bachelor’s degree preferred.

•             Coding Certification(s): CPC, CCS-P, CCA, CCS or RHIT, RHIA- Required.

•             5+ years’ experience preferred / 2 years minimum required.

•             Multispecialty coding exposure/experience preferred

•             EMR experience required / exposure to various EMRs preferred

•             Proficient use of Microsoft Office Applications (Excel, Word, Outlook,  Teams)

Physical Job Requirements:<