Medical Billing and Coding Specialist

GENERAL SUMMARY OF DUTIES:    Oversees processing of professional and facility charges in accordance with current ICD and CPT guidelines.

EXAMPLES OF DUTIES: (This list may not include all of the duties assigned.) 

 

1.                Gathers, reviews and corrects professional and facility charges which includes checking for patient demographic information accuracy and total charges through review of patient charts. 

2.                Evaluates medical record documentation and charge-ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflects and supports outpatient visits and to ensure that data complies with legal standards and guidelines. 

3.                Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD and CPT codes. 

4.                Works with physicians to resolve coding issues. 

5.                Works with hospital staff to coordinate inpatient consultations. 

6.                Participates in educational activities. 

7.                Maintains strictest confidentiality. 

PERFORMANCE REQUIREMENTS: 

 

Knowledge of ICD and CPT coding guidelines, reimbursement practices.  Knowledge of coding and clinic operating policies. Ability to read and interrupt medical procedures and terminology.  Ability to examine documents for accuracy and completeness.  Ability to prepare records in accordance with detailed instructions.  Ability to work effectively with patients and co-workers.  Ability to communicate clearly. 

 

Education:  High school diploma or GED. 

 

Experience:  Two years of experience in medical record coding preferred but not required. 

 

Certificate/License:  Medical Billing & Coding Certification is preferred but not required.