Coding Specialist

Reports To:

Business Office Manager

Organizational Peers:

Business Office Personnel

Job Summary:

Coding Specialist is a nonexempt position responsible for front office and general coding billing duties. Responsible for Coding Audits, Claim, Billing review and compliance.

Performance Requirements:

Knowledge

• Knowledge of billing practices and clinic policies and procedures.
• Knowledge of coding and clinic operating policies.
• Knowledge of medical terminology
• Knowledge of health care insurance claim practices and compliance.
• Knowledge of computer systems, programs, and applications.

Skills

• Proficient skills in computer programs.
• Skill in using a calculator.

Abilities

• Ability to understand and interpret policies and regulations.
• Ability to read and interpret medical charts.
• Ability to examine documents for accuracy and completeness.
• Ability to communicate effectively and work with others.

Major Duties and Accountabilities:

• Coordinates with clinical staff to verify charge and/or documentation information as needed
• Audits information about procedures performed and diagnosis on charge.
• Audits 100% of new provider claims
• Audits providers quarterly for correct coding and optimal reimbursement
• Provides education to clinical staff as necessary with coding/documentation
• Reports quarterly on Bell Curves
• Responsible for Athena Work Lists as apply to med necessity and/or coding denials
• All other duties as assigned by the Business Office Manager

Position Competencies:

• Role model for organization’s core values
• Customer Service: Demonstrates the highest standards for friendly, courteous and caring interaction with patients, physicians, customers, and fellow employees.
• Professional presence
• Communication: Demonstrates ability to accept and understand instructions, expresses self clearly and concisely.
• Adaptability/Flexibility: Demonstrates the ability to cope with pressure, grasp new ideas and methods, and adjust responses to meet the changing work environment.
• Independence/initiative: Demonstrates reliability, follow through, ability to work with minimum supervision, and desire and ability to accept additional responsibility.
• Confidentiality
• Emotional Intelligence: Maintain basic emotional and social competencies to include self-awareness, self-regulation, motivation, empathy, and social skills.

Job Qualifications:

• Equipment operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, calculators, etc.
• Education/Experience: Must have a high school diploma/Certified Coder and a minimum of one year coding experience in a health care organization.
• Physical: Position is in a well-lighted office environment and sitting and standing associated with a normal office environment.