What are the responsibilities and job description for the Medical Coding Specialist position at Community Care Network Of Va?
At Cenevia, we eliminate operational burdens so our healthcare delivery champions can focus on providing high-quality and cost-effective health outcomes. Since 1996, Cenevia has been a trusted support system, training partner and business process expert for health providers, including Federally Qualified Health Centers (FQHC), private practices, hospitals, managed care organizations, and provider networks.
Cenevia provides integrated, network-based services and programs to healthcare clients to help them run their businesses better so that they can focus on patient care. This includes the centralized practice management system, help desk, and support infrastructure that Cenevia established in 1999.
The Cenevia staff includes experienced health care professionals from the following areas:
- Revenue Cycle Management
- Quality Improvement
- Health Information Technology
- Health Plan Contracting
- Credentialing and Enrollment (NCQA-certified)
Summary/Objective:
The Medical Coding Specialist is responsible for translating patient information from medical records to analyze, extract, and assign appropriate codes (i.e., ICD-10 and CPT code) for accurate claims, billing, and data management purposes.
Essential Functions:
Core duties and responsibilities include the following. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.
Coding
- Accurately code patient diagnoses and procedures, ensuring compliance with healthcare regulations, and managing medical billing processes.
- Review medical records to verify accuracy and ensure that all necessary information is present for coding purposes.
- Collaborate with healthcare providers to clarify any discrepancies in patient records or coding.
- Stay updated on changes in coding regulations, billing practices, and insurance policies.
- High level of proficiency with CPT and ICD-10 codes.
Claims Processing
- Account inquiry review
- Proficiency in patient insurance demographic data
- Billing alert creation and deletion
- Claims processing (both paper and electronic)
- Management of clearinghouse rejected claims
Client Communication
- Exemplary client service and communication skills, serving as client liaison
Core Values
- Professional communications to clients and company employees
- Patient phone calls and interpretive management services
- Continued education
- Special projects given by the department Director
QUALIFICATIONS:
- Proficiency in medical terminology, anatomy, physiology, and coding systems (ICD-10, CPT, HCPCS) is essential.
- Familiarity with medical billing processes and functions
- Candidate should be proficient in using Microsoft Excel and Word.
- Must have excellent customer service skills.
- High school diploma or equivalent required.
- CCS or CPC certification required.
COMPETENCIES:
To perform the job successfully, an individual should demonstrate the following competencies:
- Accountability and Results - Assuming responsibility for successfully completing assignments or tasks; self-imposing excellence standards rather than waiting for others to impose or enforce them.
- Client Focus - Anticipating, understanding, and fulfilling customer needs and expectations by providing excellent direct and indirect service.
- Productivity - Ensuring efficiency requirements are met even in the face of time or resource restrictions.
- Quality Focus - Assuring quality standards are met within appropriate specifications by accurately checking process and tasks over time.
- Teamwork - Working effectively as part of a team through the practices of subordination, support, and cooperation.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand and walk.
The employee must occasionally lift and/or move up to 10 pounds.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
The noise level in the work environment is usually moderate.
Cenevia is an equal opportunity employer.
At Cenevia, we believe diversity brings strength and adaptability by drawing on a broad range of talents, experiences and perspectives, and affords an inclusive workplace and culture where all people, regardless of gender, race, ethnicity, sexual orientation, or background, feel a sense of belonging.
This position is remote, and employee must have suitable and secure technology to be eligible for consideration – e.g., secure Wi-Fi, telephone, dedicated workspace. Additionally, employee is required to participate and be seen in meetings via video conference as part of this role.
