Coding Specialist Certified MNPG

Job Description

Determine and apply appropriate Current Procedural Terminology (CPT) and International Classification of Diseases (ICD 10) code(s) to services for billing. With quality and reimbursement contingent upon coding, it is the responsibility of the Physician Group Coding Specialist to have proper training in ICD-10, CPT-4, HCPCS and AAPC coding rules and principles. Coder has frequent interactions with internal and external clients. Coder focuses their work on detailed documentation abstraction from the EHR or other document and selection of CPT and DX coding based on this review. Perform 100% coding and billing review for all new Mount Nittany Physician Group providers. Serves as the liaison for immediate and ongoing documentation and improvement for physician coding practices, compliance and revenue optimization for all practices.

Minimum Requirements

Education:

• Associates Degree from an approved Health Management Technology program or relevant Technical Certification preferred. May have an equivalent combination of education and/or experience in lieu of specific

Experience:

• Two (2) years of previous experience in diagnosis, E/M, and procedure coding preferred.

Knowledge, Skills, Abilities:

• Demonstrates knowledge of diagnostic and procedural terminology, medical terminology and disease processes (anatomy and physiology).
• Self-motivated individual with personal integrity to organize work and work independently.
• Possesses typing skills with basic knowledge of computer operations.
• Demonstrates communication skills necessary to communicate to the clinical staff, physicians, managers, etc. for any clarifications regarding record questions or problems utilizing coding rules and principles.

License/Certification/Registration:

• Certified Professional Coder (CPC) credential required within 1 year of hire/transfer.
• Must maintain Certified Professional Coder (CPC) or other relevant credential by completing continuing education requirements.
• Registered Health Information Technician (RHIT) credentials, Certified Coding Specialist (CCS), Certified Professional Coder (CPC) or other relevant credential, relevant experience, required upon hire/transfer.

Supervision Received

Receives general supervision from the Supervisor, HIM Coding.

Supervision Given

None

Responsibilities

Essential Functions

• Assigns appropriate codes for diagnoses, treatments and procedures using the appropriate classification system, e. g. the International Classification of Disease system with exceptions, as required, for various third party payers, maintaining a 95% accuracy rate.
• Communicates with nursing and ancillary services personnel for needed documentation for accurate coding. Works with providers to resolve coding issues, request diagnoses when information is not recorded and ensure patient information is complete.
• Mentors and assists in training of other coders within the practice. Participates in the development of coding policies and procedures as identified. Assists in the oversight of the work of fellow coding employees through regular internal audits.
• Coordinate with the Lead for new Mount Nittany Physician Group providers including attending new provider education. Conducts 100% review of all new Mount Nittany Physician Group providers ensuring 80% accuracy has been reached. Communicate any trends or improvement needs with provider documentation directly to the provider, practice manager and coding lead for education purposes.
• Cross-trains to cover various practices, as needed.
• Interacts with Revenue Cycle to alert them to trends found through coding reviews.
• Meets Performance Standards outlined.

Non-Essential Functions

Performs related and miscellaneous duties as assigned.

About Us

Why Mount Nittany Health? At Mount Nittany Health, we provide high-quality patient care with a unique combination of the latest in clinical technology and compassionate medical professionals. We are committed to improving both the quality and availability of healthcare in our region and seek to hire only the best to support the communities we serve.