By joining our team, you'll be part of our life-changing Mission and Vision. You'll work in a truly inclusive environment where diversity and equity are championed through words and actions. You'll contribute to an innovative culture that is second to none, one that embraces curiosity, discovery and compassion. You'll play a role in something that's never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes - as we Advance Human Ability, together.
Job Description Summary
The Coding Specialist is responsible for reviewing, identifying and coding for office services, hospital consults, and hospital surgeries utilizing appropriate CPT and ICD-10CM codes to support clinical operations and maintain compliance with regulatory bodies. The Coding Specialist will be trained in therapy coding and assist as needed with billing denials and workqueue assignments. The Coding Specialist - Physicians Practice will consistently demonstrate support of the SRAlab statement of Vision, Mission, and Core Values by striving for excellence, contributing to the team efforts, and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute. The Coding Specialist - Physicians Practice will demonstrate SRAlab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and SRALAB Values (Hope, Compassion, Discovery, Collaboration, & Commitment to Excellence) while fulfilling job duties.
Job Description
Reviews medical documentation and coding selected by providers for accuracy before and after claims are submitted to third-party organizations.
Revises coding related to edits and/or denials in accordance with ICD-10 CM, CPT Professional and HCPCS procedure codes.
Provides detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, and CPT-4 procedural codes for UB-04/HCFA outpatient or facility claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, and regulations. Works with Patient Financial Services to review medical documentation and coding to remedy and/or support billing clarifications and questions by internal and external organizations or third parties.
Assists management to identify trends and opportunities for improvement as it relates to coding and billing.
Ensures information is captured, maintained, and handled according to hospital bylaws and standards established by regulatory and accreditation agencies.
Remains current on topics, significant decisions, and technological advances affecting regulatory compliance, and coding through available resources and webinars.
Assists in additional activities as requested by Corporate Compliance and Patient Financial Services.
Perform all other duties that may be assigned in the best interest of Shirley Ryan AbilityLab.
Reporting Relationships
Reports to the Manager, Medical Records Coding.
Knowledge, Skills & Abilities Required
High School Diploma or GED. Completion of an accredited certification program with one of the following credentials: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) OR Current Certified Professional Coder (CPC), or Certified Professional Coder - Apprentice (CPC-A) pending fulfillment of the 2-year experience (on-the-job coding) requirement.
Will accept a combination of any of the 2 of the following in lieu of: - Proof of 80 contact hours of a medical coding preparation course, completion of CPC-A Practicode, - 1-year on the job experience. - Two to four year degree in Health Information Management accredited by the American Health Information Management Association (AHIMA) is preferred. Experience and knowledge of CPT, ICD-10-CM, modifiers, and HCPCS coding systems required for accurate assessment of CPT codes, and other assignments in hospital inpatient and outpatient settings.
At least 2 years of recent hospital, ambulatory and/or physician coding and billing experience.
Provider experience strongly preferred. Possesses detailed understanding of principles, methods, and techniques related to compliant healthcare billing/collections.
Knowledge of insurance billing including Commercial, Medicare, Public Aid, et.al.
Analytical skills necessary to assist with identification of patterns/trends based on audit activities.
Must be able to set and organize work priorities and adapt to them as they change frequently.
Proficient in Microsoft products including EXCEL and WORD. Ability to maintain patient/physician confidentiality.
Working Conditions
Normal office environment with little or no exposure to dust or extreme temperature.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Equal Employment Opportunity
ShirleyRyan AbilityLab is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
