Coding Specialist

Wilmington Health Coding Specialist

Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.

Provide guidance and instruction regarding insurance coding protocol to ensure compliance with regulatory requirements.

Serve as a technical resource for all coding and billing regulations for provider services

Assist in formulating policies and procedures regarding coding and billing to ensure consistency and compliance across all clinic departments

Interact with medical staff and clinic staff to ensure quality and consistency with coding and billing policies

Perform quality control reviews of internal audits

Work with designated clinic administrative staff in identifying and addressing significant coding/billing issues. This may include initiating policy changes and/or identifying areas in need of corrective action plans and assist in development and execution of action plans

Educating and training of clinic staff and medical staff

Review and update clinic fee schedule on an annual basis

Review and update of encounter forms/charge tickets on an annual basis

Perform Evaluation and Management (E/M) profiling on a monthly basis

High school diploma or equivalency

3-5 years health insurance experience, Certified Coder CPC, CCS-P

Abstract coding experience

Wilmington Health is an Equal Opportunity Employer committed to providing equal opportunities to all applicants and employees. We are committed to treating everyone equally and with respect regardless of race, age, sex, religion, national origin, citizenship, marital status, veteran's status, sexual preference, disability, genetic information, or any other class protected under state or federal law.

Physical Demand - Required? - Frequency

Standing - Rarely

Sitting - Frequently

Walking - Occasionally

Kneeling/Crouching

Lifting

Customer Service

Professionalism/Integrity/Responsibility

Teamwork/Process Focus

Dependability/Punctuality

Interpersonal Relationships/Communication

Judgment/Decision Making/Problem Solving

Quality/Quantity

Initiative

Safety and Housekeeping

Organizational Skills/Time Management

Quality Management

Cost Consciousness

Motivation

Innovation

E/M audits monthly and review with physician

PRM -- add new prices, make sure codes are updated annually; update ICD-9 file annually

Update charge sheets annually and as needed

Update Experior when patients re dismissed from practice or from individual physicians and talk to patients with questions

Read monthly Medicare, Medicaid, and coding bulletins; update appropriate staff and physicians

Be available to staff and providers for coding questions

Special project audits--i.e., shared visit documentation, Medicare audit requests, patient complaint audits