Medical Billing Coding Specialist II

Job Description

Job Description

Job SummaryThe Medical Billing Coding Specialist II will help our communities thrive by ensuring our practice remains compliant with documentation and coding during claims billing process. We are a culture that is unabashedly driven by purpose. We are making a difference to our patients and providers while growing at an accelerated rate.Every day, we support the health journey of patients by authentically living our core values: Purpose Driven, Relationships Matter, Serve Others First, and Inspire Creativity. If you love serving others and would like to make a material difference in an industry-transforming organization, then we invite you to apply to this role. We are recognized as one of the Top 100 Places to Work by The Dallas Morning News, and we have been awarded as one of the fastest-growing privately held companies by SMU Cox.AccountabilitiesUses Technical and Functional ExperiencePossesses up to date knowledge of the profession and industryAccesses and uses resources when appropriateDemonstrates AdaptabilityHandles day to day work challenges confidentlyIs willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid changeShows resilience in the face of constraints, frustrations, or adversityDemonstrates flexibilityCustomer ServiceDemonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients as well as outside contacts so that productivity and positive employee/patient relations are maximized.Uses Sound JudgmentMakes timely, cost effective, and sound decisionsRole and Responsibilities:Perform paper and EMR chart audits for all providers in accordance with third party and CMS requirements.Ensure captured charges and billings accurately reflect the medical record according to ICD-10, CPT, HCPCS, and CMS guidelines.Coordinates, schedules, and performs the professional services documentation and coding audits of outpatient records for the practice.Responsible for maintaining up to date knowledge of coding guidelines as they relate to services rendered such as AMA guidelines, Medicare LCD's, commercial payor billing guidelines, coding manuals.Develop and coordinate educational and training programs regarding elements of coding such as appropriate documentation, accurate coding, coding trends found during chart reviews, third party audit findings, and annual coding updates.Recommends procedural improvements and training opportunities to management. Maintains the confidentiality of medical information contained in each record.Assists with other audits such as hospital visits, consultations, and others as assigned.Assists with CHG audit and compliance or reimbursement audits such as providing records, audit reports, and standard operating procedure manuals.Performs Chart AuditsWorks with healthcare providers to identify areas of coding opportunity to ensure compliance and maximize revenue. Develops training material and leads training.Demonstrate knowledge of state, federal, and third-party claims processing required.Demonstrates knowledge of payer-specific coding requirements.Minimum Qualifications and Requirements:High School diploma.CPC Certification required.Minimum four (4) years of combined medical billing and payment experience required.Must possess a broad knowledge of managed care and HMO policies and procedures and Medicare benefits. Must possess a strong knowledge of current versions of ICD10, CPT, and HCPCS.Demonstrate knowledge of medical coding.Performs Chart AuditsMust possess a broad knowledge of managed care and HMO policies and procedures and Medicare benefits. Must possess a strong knowledge of current versions of ICD10, CPT and HCPCS.Demonstrate knowledge of medical coding.Proficiency with computer systems and Microsoft Office (Word and Excel) required.Preferred Experience:· Associate degree in finance, Business