Medical Coding Specialist

The Medical Coding Specialist is responsible for obtaining charge capture data from the electronic medical records (EMR) and keying this information into the patient management system daily for multiple assigned locations.

• Review medical notes and records to identify proper coding of claims.
• Assigns and translate codes for different services and diagnosis.
• Review physicians’ notes and charts for accuracy.
• Maintain current knowledge of coding and keep current with medical compliance and reimbursement policies impacting claims payments.
• Responsible for daily entering and organizing of codes from EMR into billing management software.
• Familiar with ICD10 and CPT/HCPCS universal coding systems.
• Obtains necessary clarification with clinical managers and nursing staff to ensure appropriate billing and charge capture.
• Manage and track missing charge capture reports or billing information, ensuring timely entry of information prior to month end.
• Monthly audit of assigned locations (10% of charts).
• Other audits as assigned.
• Enter information into compliance log for evaluation by compliance officer and Director of Billing.
• Work closely with other billing staff to ensure compliant medical billing.

Essential Functions

• Previous clinical or coding experience.
• At least 2 years’ experience of medical billing in a Healthcare setting and CPC, required.
• CEMC, CPMA, and CHONC certifications preferred.
• Knowledge of CPT and ICD10 coding.
• Knowledge of HIPAA and OSHA rules and regulations.
• Knowledge of insurance fee schedules and contractual obligations.
• Problem Solving.
• Maintains confidentiality.
• Balances team and individual responsibilities.
• Displays willingness to make decisions.
• Demonstrates accuracy and thoroughness; looks for ways to improve and promote quality.
• Observes safety and security procedures; reports potentially unsafe conditions.
• Ability to communicate effectively both written and verbally.
• Ability to effectively present information and respond to questions from group of managers or peers.
• Strong analytical and conceptual skills.
• Ability to interpret a variety of instructions furnished in written, oral, or schedule form.
• Basic computer skills.
• Familiarity with billing applications and basic Microsoft Office and Windows applications.

Desired Degree

High School