As a Coding Specialist, your primary responsibility is to ensure accurate and compliant coding of medical services and procedures for reimbursement purposes. You will play a crucial role in translating healthcare providers’ documentation into alphanumeric codes, adhering to industry coding standards and guidelines. This position requires a strong understanding of medical terminology, coding systems, and compliance regulations.

Key Responsibilities:

Coding and Abstracting:

• Assign appropriate diagnostic and procedural codes to patient encounters based on documentation provided by healthcare providers.
• Review medical records and other documentation to identify relevant information for accurate code assignment.
• Ensure coding is in compliance with Current Procedural Terminology (CPT), International Classification of Diseases (ICD), and Healthcare Common Procedure Coding System (HCPCS) guidelines.

Compliance:

• Stay updated on changes in coding regulations, guidelines, and healthcare policies.
• Perform regular audits to ensure coding accuracy and compliance with relevant coding standards.
• Collaborate with compliance officers and participate in coding education programs to maintain a high level of compliance within the physician practice.

Communication:

• Work closely with physicians, nurses, and other healthcare providers to clarify documentation and obtain additional information when necessary.
• Communicate coding-related updates and changes to the healthcare team to facilitate accurate and efficient coding practices.

Coding Software and Tools:

• Utilize coding software and electronic health records (EHR) systems proficiently.
• Ensure the integrity of coded data and resolve discrepancies as needed.

Reporting and Analysis:

• Generate reports on coding accuracy, compliance, and reimbursement trends.
• Analyze coding-related data to identify areas for improvement and implement corrective actions.

Training and Education:

• Provide training and education to healthcare providers and staff on coding documentation requirements and best practices.
• Stay informed about industry best practices and advancements in coding technologies.

Customer Service:

• Assist in responding to coding-related inquiries from internal and external stakeholders.
• Collaborate with billing and reimbursement teams to address coding-related issues impacting revenue cycle management.

Qualifications:

Education: High school diploma or equivalent; coding certification (e.g., CPC, CCS) is preferred.

Experience: Previous coding experience in a physician practice or healthcare setting is required.

Knowledge: Proficient understanding of CPT, ICD, and HCPCS coding systems; familiarity with medical terminology, anatomy, and physiology.

Skills: Strong attention to detail, analytical skills, and proficiency in using coding software and EHR systems.