Coding and Documentation Review Specialist

Job Title

Responsible for the review of provider documentation and coding charge review errors as well as Evaluation and Management coding. Ensure that the coding is appropriate before releasing the claims to be billed. Identify trends and opportunities for improved documentation and billing and communicate those trends with the Coding Educators and providers. Must be fluent with the Evaluation and Management / CPT coding guidelines, ICD10 coding guidelines for outpatient, inpatient, observation coding including but not limited to all office-based services, procedural coding and hospital rounding.

Job Description

Review documentation and coding for both inpatient and outpatient (hospital and office) professional services before the release of charges. Queries the provider of items in the chart that need to be reviewed or corrected as it relates to the coding selected. Responsible for monitoring regulatory changes as they apply to billing and coding in the inpatient and outpatient setting. Serves as resource to the practices/departments for data mining and coding to ensure reimbursement accuracy. Identifies coding issues related to billing denials, collaborates with the Coding Educator and Revenue Integrity as needed to assist with the preparation of training materials and examples to prevent future coding/billing issues. Accurately code CPT and diagnoses. Expected to maintain department productivity standards and accuracy rates.

Position Requirements and Qualifications

Education: High School diploma required. Coding certification(s): CPC, RHIT, CCS.

Skills: Must be able to interact in a positive manner with physicians, nurses and other team care members. Demonstrates personal initiative, team spirit, and service orientation while maintaining a positive, caring, professional attitude. Excellent research skills as it relates to medical specialties, documentation and coding requirements. Dependable, motivated, professional and work well independently or with a group. Medical terminology, ICD10 proficiency, CPT proficiency. Highly organized and pays close attention to detail. Strong written and verbal abilities.

Experience: Minimum of 1 year coding experience. 1-2 years practice operations/revenue cycle experience. Knowledgeable in electronic health record systems. Microsoft Word and Excel.

Posted Salary Range

USD $65,000.00 - USD $80,000.00 /Yr. This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate's qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits. At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.