Provider Coding Specialist II

• Performs coding of charge sessions in assigned work queue using established coding and regulatory guidelines for Provider Based, Method II, Rural Health, and free-standing clinics.

• Collaborates with billing and customer service team to resolve insurance denials and patient disputes in a timely fashion utilizing established workflows

• Conducts provider queries of identified documentation issues utilizing EHR established workflows

• Utilizes computer assisted coding tools, in accordance with, established coding workflows.

• Collaborates with coding reviewer by providing feedback regarding trends identified during the daily coding process and attends provider reviews as assigned,

• Prioritizes coding functions as directed by coding leadership and organizes job functions and work assignments to efficiently complete tasks within the established time frames

• Participates in meetings including, departmental, provider, clinical operations, billing using virtual technology or face to face as needed.

• Maintains communication and relationships with PFS billing and customer service staff.

• Performs other duties as assigned.

• Accredited Program Required: Codingor combination of education and experience that provides the caregiver with the requisite knowledge, skills and abilities to perform the job

• Minimum of 3 years Required: Experience in physician professional coding in a medical care facility, billing office or medical records department

• Certified Coding Specialist Physician

• Certified Professional Coder other HIM recognized; related credential

• Certified Coding Associate

• Certified Coding Specialist

• Registered Health Information Administrator

• Registered Health Information Technician

• Certified Outpatient Coder

• Certified Professional Coder - Hospital

• Proficiency in coding Professional Inpatient and/or Ambulatory Care, Emergency Department and Outpatient medical records with ICD-10 CM and CPT4 classification systems with expertise in one or more specialty area. (Required)

• Proficient in the use of MS Office applications including Excel and Word. (Required)

• Adept and proficient in windows-based computer environment with respect to coding software systems. (Required)

• Good verbal and written communication skills (Required)

• Critical thinking and problem-solving skills. (Required)

• Familiarity with medical billing software and electronic medical record. (Preferred)

• Knowledge including, as appropriate, ICD-10, and HCPCS/CPT coding, regulatory Medicare, Medicaid and third-party regulations. (Required)

• Consistently operates computer and other office equipment.

• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

• Sedentary work.

• Predominantly operates in an office environment.

• Ability to communicate and exchange accurate information.

• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

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