Coding Specialist

RCM Medical Coding Specialist Location Requirements Must reside in the following states: AL, AZ, FL, GA, IL, IN, KS, KY, MI, MN, MO, NC, NJ, OH, OK, PA, TX, VA. SUMMARY The Medical Coding Specialist will evaluate medical records and charge tickets to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual - Clinical Modification (ICD-9-CM/ICD 10)) and the American Medical Association's Current Procedural Terminology Manual (CPT). The Specialist will also provide technical guidance and training on medical coding to physicians and staff. ESSENTIAL DUTIES AND RESPONSIBILITIES Evaluate medical record documentation and charge-ticket coding to optimize reimbursement by ensuring diagnostic and procedural codes, and other documentation, accurately reflect and support outpatient visits via data compliance with legal standards and guidelines. Review medical records and both identify and address any documentation or charge discrepancies. Interpret medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-9-CM and CPT codes. Perform edit checks on data entered prior to transmittal and correct errors as indicated. Research, analyze, recommend, and facilitate plans of action to correct discrepancies and prevent future coding errors. Provide technical guidance to physicians and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and codes that do not conform to approved coding principles and guidelines. Collaborate with RI Specialists and the Denials team on reviewing state and federal Medicare reimbursement claims for completeness and accuracy before submission to minimize claim denial. Assist lead or supervisor in educating and advising staff on proper code selection, documentation, procedures, and requirements. Develop and update procedure manuals to maintain standards for correct coding, to minimize the risk of fraud and abuse, and to optimize revenue recovery. Read bulletins, newsletters, and periodicals, and attend workshops to stay abreast of issues, trends, and changes in laws and regulations governing medical record coding and documentation. Participate in team meetings and activities to support the goals of the team and department. QUALIFICATIONS Knowledge of ICD-10-CM and CPT coding guidelines, medical terminology, and both state and federal Medicare reimbursement guidelines. Experience with the utilization of modifiers and other coding rules to include the AMA and other coding organizations. Excellent written and verbal communication skills to prepare reports and related documents and to maintain working relationships with physicians and other staff. Ability to apply and understand payer requirements. Ability to prioritize and resolve multiple tasks with excellent problem-solving skills. EDUCATION AND/OR EXPERIENCE Minimum required: HS or G.E.D. Minimum required: 2+ years of medical coding experience OR completion of A.A. or A.S. in medial coding and billing, medical administration, or a related field. LICENSES AND CREDENTIALS Minimum required: CPC, RHIT, ART, or CCS coding credentials. SYSTEMS AND TECHNOLOGY Proficient in Microsoft Excel, Word, PowerPoint, Outlook. Experience with EHR software systems. PHYSICAL REQUIREMENTS While performing the duties of this job, the employee is regularly required to talk and hear. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds. VISION REQUIREMENTS Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. EEO STATEMENT EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. #J-18808-Ljbffr