Coding Complex Specialist/Full Time/Remote

CBO Coding Complex Specialist

Under established coding principles and procedures reviews, analyzes, and validates the diagnostic and/or procedural codes applied from front-end coding and clinical teams for reimbursement and billing purposes. The CBO Coding Complex Specialist accurately abstracts information from the electronic health record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, and regulation and accreditation guidelines.

Education/Experience Required:

• High school diploma or G.E.D. equivalent required.
• Minimum of two (2) years coding experience required.
• Additional specialty coding certification or five (5) years coding experience required.
• Prior experience in a healthcare revenue cycle position required.
• Specialty coding experience preferred.
• One to two (1-2) years college or additional course work in Accounting, Business, Healthcare Administration or Medical Record Sciences preferred.
• Must have thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.
• Strong organizational and time management skills required to effectively prioritize work.
• Ability to communicate effectively with colleagues, supervisor, and manager.
• Ability to work independently.
• Ability to work remotely.
• Proficient in medical terminology.
• Proficient in ICD-10 CM, CPT and HCPCS coding.
• Able to recognize patterns and trends and escalate to supervisors to support root-cause analysis.
• Able to assist other team members.
• Supports the standards set forth in the HFHS Code of Conduct by adhering to legal and ethical guidelines.

Certifications/Licensures Required:

• Certification as a Registered Health Information Technician (RHIT), CPC, or CCS certification required.