Coding Specialis - United Surgical Partners International Inc (USPI)

Position Overview:

Reporting to the Coding Manager, the Coding Specialist is responsible to provide accurate and CCI compliant CPT and ICD-10 diagnosis coding of 1800-2200 cases per month of multi-specialty nature-ASC specific resulting in claims reimbursements. Field questions from clients in a timely manner by researching authoritative sources and providing accurate answers. Manage time efficiently and consistently meet 2448-hour coding turnaround deadline. Stay current on CMS, AMA, and ICD coding news and updates. Maintain current organizational coding certification by obtaining required annual CEUs.

Responsibilities:

• Review and analyze medical records to identify diagnoses, procedures, and services provided.
• Assign appropriate ICD-10 codes to reflect the diagnoses and procedures documented in the medical records.
• Ensure coding accuracy and compliance with coding guidelines, regulations, and payer requirements.
• Manage daily coding email queues providing responses within 3 business days.
• Problem-solve claim edits and support the denial process as requested.
• Uphold productivity standards / goals set by coding leaders.
• Maintain coding quality accuracy rate of 95.5%.
• Identify documentation issues (lacking documentation) that impact coding accuracy.
• Clearly communicate (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.
• Must possess knowledge of third-party reimbursement regulations and billing practices.
• Ability to examine documents for accuracy and completeness.
• Ability to understand and follow compliance issues of moderate complexity by utilizing appropriate coding/compliance resources.
• Must possess moderate knowledge of CCI edits and LCDs and be able to accurately apply regulation knowledge to coding situations.
• Additional duties as assigned.

Requirements:

• RHIA, RHIT, CPC, COC, CASSC, or CCS certification required.
• Associates degree in relevant field preferred or combination of equivalent of education and experience.
• Must have knowledge of AMA, CMS, and CPT coding guidelines.
• Knowledge of ICD-10-CM, medical terminology, anatomy & physiology.
• 2+ years of ASC revenue cycle or coding experience.
• Proficient in Microsoft Word, Excel.
• Ability to maintain required productivity and accuracy standards.
• Excellent verbal and written communication skills.
• Ability to prioritize workload, handle competing priorities, while meeting or exceeding deadlines.