Coding Specialist Fully Remote

Coding Specialist

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Hours:

7 am - 3:30 pm
- Mon
- Fri (no weekends)

Fully Remote!!!!

The Coding Specialist is responsible for supporting Penn Medicine Lancaster General Health Physicians (LGHP) by reviewing, promoting, and evaluating professional coding and professional fee billing. This position serves as a first point of contact for coding inquiries and acts as a resource to practices for coding issues and education. The Coding Specialist helps to optimize revenue through appropriate coding while adhering to official coding guidelines for the purpose of assuring accuracy and compliance when billing insurance carriers.

This position is responsible for the performance of annual chart reviews of professional fee billing specifically for LGHP and certain LGH Practices. To ensure accurate and appropriate gathering of information into the coding classification systems to meet departmental, hospital and outside agency requirements. This includes ensuring appropriate reimbursement, compliance and charging with the various coding guidelines and regulatory agencies. Responsible for obtaining accurate and complete documentation in the medical record for accurate coding assignment, severity of illness and risk of mortality for each medical record.

This position is an integral part of the revenue cycle as it pertains to physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives. Responsible for analyzing and resolving issues of missing charges and problem accounts by researching information regarding department reimbursement.

Accountabilities

• Perform systematic reviews of professional fee billing and coding for non-governmental carriers using an established point system ensuring that documentation supports billed services.
• Ability to educate providers from research and audit findings as needed.
• Compiles and prepares materials for meetings as necessary; ensures accuracy of information provided.
• Prepare and present coding education to new providers joining the practices to ensure understanding current evaluation and management guidelines Identify patterns in denials working with appropriate parties to correct errors and mitigate future errors.
• Research topics with the capability to interpret complex rules and regulations.
• Keeps abreast of CPT coding changes
• Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas
• Contacts physicians or any persons necessary to obtain information required to accurately code assignments.
• Works and communicates with other offices in any manner necessary to facilitate the billing process.
• Monitors on an on-going basis provider documentation. Performs audits to assess provider coding accuracy and follows up with provider education as needed.
• Provides assistance to Revenue Cycle Operations in claim development functions to resolve problem patient accounts.
• Prepare and present coding education to new providers joining the practices to ensure understanding current evaluation and management guidelines
• Review and resolve charges in work queues based on payer edits, CCI edits, and coding-related denials
• Collaborate with customer service department to resolve coding-related patient complaints
• Monitors payer guidelines to ensure accurate coding, including local Medicare Administrative Contractor guidance, state payer rules, regulations, and trade publications.
• Assist the team with occasional special projects
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures
• Other duties…