Coding Specialist III (31756)

Position Purpose Performs various duties to accurately interpret and bill physician charges for physician services. Enters into the Billing System appropriate CPT and ICD-10 codes and bills charges. Responsibilities Performs initial charge review to determine appropriate ICD-10 and CPT codes for reporting physician services to third party payers. Assists in entering patient data from facesheets, including demographics, insurance plans, and related information. Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services. Enters appropriate data into gPM selecting the correct codes, diagnosis, modifiers, anesthesiologist, CRNA, pathology, and provider information to complete the process. Contacts physicians through management regarding procedures and services billed to ensure proper coding. Reviews patient logs and reports of clinical activity to verify all billing is captured for all patients. Monitors and follows up to capture all billable services and ensures coding accuracy. Ensures batch processes for all coded charges are completed correctly. Reviews all physician documentation to ensure compliance with third‑party and regulatory guidelines. Works with the Reimbursement staff to answer coding and billing inquiries for GI Alliance physicians and pathology services. Coordinates with other members of the Central Billing Office as necessary. Participates actively in problem identification and resolution, coordinating between appropriate parties. Scrubs claims to submit compliant, truthful, and correct coding based on payer rules. Performs other related duties as required and assigned. Qualifications High school diploma or GED completion is required. Must hold a Professional Coding Certification with AAPC: Certified Professional Coder (CPC). Minimum 5 years of experience working with EMR and in medical coding. Requirements for Level III Status Should be a leader and viewed as a leader by other staff. No performance or disciplinary actions in the last year. Serves as a mentor/trainer for new hires in the field. Considered a subject‑matter expert by peers, management, and physicians. Performance Requirements Good working knowledge of medical terminology and anatomy. Knowledge of current third‑party billing and collection regulations and requirements. Strong interpersonal, written, and verbal communication skills. Ability to gather and interpret clinical data. Ability to utilize Microsoft Office and perform alphanumeric data entry. Strong attention to detail and decision‑making skills. #J-18808-Ljbffr The Specialty Alliance