Coding Specialist, Senior - Chesapeake Regional Healthcare

The Senior Coding Specialist is responsible for performing coding tasks required to promote efficient operation of the physician practices within Chesapeake Regional Medical Group.

Essential Duties and Responsibilities

These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.

• Obtain pathology and operative reports from hospital systems
• Assign and sequence ICD diagnostic, procedural, and CPT codes to ASC records
• Identify all complicating conditions/co-morbidities to ensure optimum reimbursement
• Maintain established productivity requirements
• Accurately enter various code and charge information into information system
• Review appropriate reports for validation of accurate transmission
• Resolve transmission errors and resubmit claims
• Report all payments on collection claims to the Collections Specialist(s)
• Attend required hospital-wide orientations, meetings, and in-services
• Demonstrate a commitment to flexible work scheduling when necessary to ensure patient care
• Complete all assigned charge entry, coding, billing, & follow up in timely manner.
• HOLD Bucket/worklist-assist & train Billing Reps for all practices/departments/locations
• Back up phone coverage for all practices/departments/locations patient statement calls & CRMG, CRNI, & SAS staff support.
• Refunds & Training staff on Refunds for all practices/departments/locations
• A/R Aging wizard for all practices/departments/locations
• Internal Audits –for all practices/departments/locations
• Support with new practice go lives
• Comprehension of payer guidelines for appeals, overpayments, retractions, refunds, eligibility, reconsiderations, referrals, authorizations, payer websites, filing limitations, denials, and attachment requirements to work all claims to a zero balance in a timely manner.
• Retrieve of clinical or financial documents from other scanning program, i.e. onbase
• Handle Release of Information request
• Participate/attend approved Healthcare/Insurance webinars/seminars
• Maintain up to date working knowledge of your assigned payors LCD/NCD, CPT and ICD9/ICD10
• Attend and participate in monthly billing meetings
• Report to manager on a weekly/monthly basis any scheduled/assigned tasks/projects
• Create case to coding team member any claims in your assigned worklist that pertain to a coding issue.
• Front Desk Support post go-live of new electronic medical record.
• Possess the ability to fill in as patient service representative as directed by manager

Education and Experience

Minimum Required Education: High school diploma

Preferred Education: Courses in Medical Terminology and Ancillary Testing

Experience: One or more years in hospital and/or medical office experience with a typing speed of 35+ wpm and proficient knowledge of computer functions and operations

Certificates, Licenses, Registrations

Applicant must have current Certified Professional Coder (CPC) certification or obtain CPC certificate within one year of hire date.

PI250578843