Provider Coding Specialist

Employee Type:RegularWork Shift:Join Team Tidelands and help people live better lives through better health!Provider Coding Specialist Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day. A Brief Overview Under the supervision of the Coding Supervisor, the Provider Coding Specialist is responsible for analyzing and assigning ICD-10-CM diagnostic codes, CPT, and HCPCS codes to professional surgical patient accounts, based on the medical information provided and consistent with regulatory guidance and best practices in the industry and Organization policy and procedure. Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify documentation to ensure accurate code assignment. Organizes and prioritizes work to meet deadlines and goals. Maintains and expands knowledge of coding and sequencing guidelines to ensure coding compliance and accuracy. Responsible for resolving coding edits, account checks, rejections, and denials to ensure proper reimbursement of service rendered and to maintain an industry standard clean claim rate. What you will doAnalyze 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 requiredEnter charges for procedures that are not soft coded as instructed for certain patient typesConsistently meet coding quality and productivity standards established by the coding departmentWork 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 reimbursementGather and verify all information required to produce a clean claim including special billing procedures that may be defined by a payer or contractReview 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 submissionCollaborate with the Compliance/Quality Team when alerted to coding quality issues found via internal or external reviews; implement with accuracy coding quality recommendationsWork 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 resolutionReview and code Orthopedic, OB/GYN, and other surgical specialties procedures with minimal supervision, ensuring correct coding and sequencing of diagnoses and proceduresProvide continuous education and feedback to surgeons and clinical staff regarding ICD-10 coding and documentation best practices for surgical proceduresEducation QualificationsHigh School Diploma RequiredExperience Qualifications2+ years of abstract coding for physician services RequiredMinimum of four years of healthcare experience, with at least three years of professional coding experience in Orthopedics or OB/GYN RequiredExperience working remotely PreferredSkills and AbilitiesBasic knowledge of ICD 10-CM diagnostic and CPT/HCPCS procedure codes principles and guidelinesBasic knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and metric systemsBasic knowledge of Standards of Ethical CodingSkills and ability to communicate effectively both orally and in writingSkills and ability to maintain working relationships with physicians and other staffSkills and ability to review the work of others and maintain confidentialityKnowledge of Microsoft Applications including (Excel, Word, PowerPoint, Outlook, etc)Strong analytical capabilitiesStrong organizational skillsAdvanced ability to function independently and be a self-starterOutstanding research skills and ability to use independent judgment to solve problemsHandle multiple prioritiesListen and acknowledge ideas and expressions of others attentivelyConverse clearly using appropriate verbal and body languageCollaborate with others to achieve a common goal through cooperationInfluence others for positive and productive outcomesReview medical record documentation and ensure accurate diagnosis and procedure code assignment to patient recordsExpertise in assigning accurate CPT®, HCPCS Level II, and ICD-10-CM medical codes and modifiers based on coding