Coding Specialist

Job Overview

This position abstracts provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers.

• High School Degree or GED
• CPC-A, CPC, CCS-P, CCA
• ICD-10-CM and CPT Coding Guidelines
• Medical terminology
• Anatomy
• Physiology
• Experience Related Fields

Assists with coding/billing questions from both internal and external customers, which will include follow up on denials, research, review of charts for potential coding issues. Follow up with provider on any documentation that is insufficient or unclear and escalate where necessary. Communicate with other clinical staff regarding documentation trends. Maintains a close working relationship with all departments and internal customers including leadership and consolidates efforts to ensure appropriate and standardized coding procedures are followed.

Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance companies, and other resources. Maintains knowledge of current coding revisions and effectively communicates changes with provider. Maintains accurate and current CPT and ICD-10-CM resources within the billing and clinical systems. Validate and abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance where applicable.

Ensure that all codes are current, active, and billable according to CCI.

• Successful completion of a certification program from an accredited organization
• Strong knowledge of anatomy, physiology, and medical terminology
• Excellent typing and 10-key speed accuracy
• Commitment to a high level of customer service
• Superior mathematical skills
• Familiarity with ICD-10 codes and procedures
• Solid oral and written communication skills
• Working knowledge of medical jargon and anatomy preferred
• Able to work independently

• Climbing – Rarely
• Concentrating – Consistently
• Continuous Learning – Consistently
• Hearing:
  Conversation – Consistently
• Hearing:
  Other Sounds – Frequently
• Interpersonal Communication – Consistently
• Kneeling – Rarely
• Lifting