Coding Reimbursement Specialist II – Revenue Cycle

Coding Reimbursement Specialist II – Revenue Cycle

Requirements

• High School Diploma or GED required
• Minimum of 1 year of coding experience required
• CPC or equivalent coding credential required
• Maintain coding certification (CPC, CCS, RHIT, RHIA)
• Working knowledge of coding, medical terminology, anatomy, and physiology
• Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers
• Understanding of and familiarity with regulatory guidelines including NCDs and LCDs.

Responsibilities

• Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered.
• Appends all modifiers.
• Ranks CPT codes when multiple codes apply.
• Assigns Evaluation and Management (E/M) codes.
• Performs reconciliation process to ensure all charges are captured.
• Processes automated or manually enters charges into applicable billing system.
• Researches, answers, and processes all edits associated with claim and coding submission.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Communicates with providers related to coding issues that are of mid to intermediate complexity. Including face to face interaction and education with providers.
• Applies modifiers and appropriate ranking to encounters with multiple codes.

Preferred Qualifications

• Dental coding experience is a plus!