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Coding Specialist

4 weeks ago

British Columbia, Canada Redeemer Health Full time

Joining Redeemer Health means becoming part of an inclusive, supportive team where your professional growth is valued. We offer programs that set up new team members for long-term success including education assistance, scholarships, and career training. With medical and dental coverage, access to childcare & fitness facilities on campus, investment in your retirement, and community events, your career at Redeemer is more than a job. You'll discover a commitment to quality care in a safe environment and a foundation from which you can provide and receive personalized attention. SUMMARY OF JOB: The Coding Specialist assigns diagnostic and procedural codes consistent with ICD-10 and CPT-4 guidelines, UHDDS sequencing guidelines, CMS coding guidelines, Medicare and Medicaid regulations and the American Hospital Association coding guidelines and it's publication, Coding Clinic, and AMA's publication, CPT Assistant, for assigned hospital based professional service areas of HRPAS employed practitioners. Responsible for consistently meeting quality expectations for documentation review, coding, and meets Redeemer Health's expected productivity standards for the position. Performs assigned duties in accordance with health system specific coding policies and procedures. The Coding Specialist will assist the assigned HRPAS hospital based providers with instruction, feedback and documentation review in their particular specialty area. Responsible for remaining current with latest healthcare technology and coding advice through reading available coding literature, attendance of seminars and in-services, internet research and other educational resources. Collaborates with charge entry personnel to ensure proper entry of diagnostic and billing codes in accordance with guidelines and for assigned areas and for trouble shooting any system or payor rejections for coding and/or documentation purposes. Performs duties in support of Redeemer Health mission to ensure the highest quality of patient care in an economically sound and efficient manner.
Registered Health Information Administrator or Registered Health Information Technician or equivalent experience, with a Certified Coding Specialist Certification.
· Must have a minimum of two years of progressive coding and/or billing and registration functions in health care setting and experience utilizing ICD-9/10-CM and CPT-4 in medical/physician specialties..
· Background in Anatomy, Physiology, Clinical Medicine and Medical Terminology.
· A graduate of an accredited coding program with certification of completion or successful completion of college credited course work in Medical Terminology, Anatomy & Physiology and Pathophysiology/Disease Processes/Pharmacology required.
· Works claim edits identified along with compliance of the Medicare Coverage Determinations ( MCD ), National Coverage Determination ( NCD ) as well as payer specific edits as outlined via contractual agreements particularly around coding matters and when other factors causing the edits are identified refers to proper person to ensure a clean claim is submitted.
· Serve as an information rescource and guide to clinicians, champion the need to change coding behaviors and serve as subject matter expert.
· Review to ensure that clinical documentation substantiates the evaluation and management, procedures and modifier selected in accordance with Federal, State and system documentation and coding requirements.
· Manage and reslove Zero-Pay Worklist, Fully Worked Receivables, complete special project work, review and respond to adjustments/payment data with approval (or initiate appeal) communicate trends and root issues through proper lines of reporting
· Requires the ability to read and interpret medical terminology and apply coding skills utilizing knowledge of anatomy, physiology and disease processes as well as procedural coding.
· Prior experience in coding mentorship and compliance review preferred particularly with physicians/providers.
· Must be detail oriented and have sound computer skills.
· Experience with review of electronic health records software applications.
LICENSE AND REGULATORY REQUIREMENTS:
Certified Coding Specialist (CCS)
We prohibit discrimination in employment due to race, color, gender, religion, creed, national origin, age, sex, sexual orientation, gender identity or expression, disability veteran status or any other protected classification required by law.