EVMS

Coding Specialist

Position Number
6771401
Department
Internal Medicine
Category
Clinical
Compensation Max
USD $54,897.00/Yr.
Compensation Min
USD $42,229.00/Yr.
US-VA-Norfolk

Overview

This position is responsible for reviewing and assigning appropriate ICD-9, ICD-10 and CPT codes to incoming work (services rendered by providers.), thereby maximizing reimbursement received from third party payors.  This position is responsible for physician/staff education based upon EVMS Medical Group Compliance Guidelines, HCFA Teaching Physician Guidelines, coding guidelines and results of chart audits. Responsible for conducting internal departmental mini-audits to ensure inpatient and outpatient medical records contain sufficient documentation to justify the frequency and type of services being billed to carriers and patients.

Responsibilities

  • Conduct regular coding education and training classes for providers and staff.
  • Make recommendations on implementing procedures for compliance within the department setting.
  • Develop Department compliance, coding, and billing policies and procedures based on the EVMSMG Compliance Plan and the HCFA Teaching Physician and Resident Guidelines.
  • Enter inpatient and outpatient charges adhering to carrier regulations.
  • Provides feedback to management as to problem areas and when proper information cannot be obtained from providers.
  • Responsible for staying abreast of insurance carrier regulation changes and informing providers, management, and staff of such changes.
  • Ongoing review of compliance, coding, and billing, literature and guidelines effecting academic medicine and surgery practice.
  • Researches and assign the appropriate CPT/ICD-9 & ICD10 code based on the provider’s dictation, and other medical records to ensure that the most accurate combination of codes is used for each patient.
  • Audits and reviews the appropriateness of the CPT, ICD-9 and ICD10 coding selections, assuring that the appropriate link between the two coding procedures has occurred.
  • Functions as liaison between the providers and EVMS Medical Group Billing Office to communicate and/or educate regarding the appropriate use of the procedural and diagnostic coding process.
  • Completes and follows up on missing Information from providers when the information provided does not support the services rendered.
  • Performs other duties as assigned.

Qualifications

Associates degree plus 4 years’ experience working with CPT, ICD-9 & ICD-10 coding in a hospital or physician office preferred. Current CPC certification or ability to sit for the test and acquire certification within 6 months is required and certification must be maintained annually thereafter.

Location : Location

US-VA-Norfolk

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