Coding Specialist

Description

Role & Responsibilities

• Work cooperatively with Northwest Health Services (NHS) providers and personnel to carry out the goals and objectives of NHS according, to governing body requirements and established internal policies and procedures. 
• Treat others respectfully whether it is a patient, fellow employee, member of management, customer, vendor or visitor to our premises. 
• Scrub claims to verify CPT, ICD-10, and HCPCS codes are appropriate for the documentation posted by the providers. Identify and report inconsistencies to the providers for corrections. 
• Assure that there are no documentation deficiencies in patient medical records. Report deficiencies to providers for corrections. 
• Submit scrubbed claims to 3^rd party insurance companies. 
• Obtain and maintain knowledge of acceptable coding and billing practices and requirements. 
• Act as a backup on as needed basis to billing staff. 
• Maintain and run EMR/PMS reports for coding and billing purposes. 
• Evaluate and make recommendations for methods to correct consistent errors through training, procedures/workflow, etc. 
• Assist in identifying weaknesses/issues in coding and documentation for the EMR and PMS software system.  Effectively communicate findings to Billing Manager. Work cooperatively with IT staff to find solutions when requested. 
• Attend appropriate workshops/seminars/meetings and in-services as directed by supervisor.  Communicate coding/billing information obtained in sessions to Billing Manager.  
• Must comply with the provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. 
• Perform related work as required. 

Qualifications

Education & Experience

• Possess high school diploma and/or equivalent. 
• Coding and Billing experience preferred.  
• Must possess ability to effectively present information and respond to questions from patients, and other individuals encountered in the course of employment. 
• Must demonstrate basic computer skills. 
• Possess light typing skills. Must demonstrate accuracy, proficiency, and efficiency. 
• Must possess and maintain a valid Driver’s License, and proof of insurance for personal vehicle used for business.  

Required Knowledge, Skills, and Abilities

1. Must be able to talk, see, hear, react, stand, kneel, walk and sit for long periods of time. 

1. Must speak concisely with a pleasant phone voice; demonstrate tact, patience and good communications skills in dealing with patients and staff. 

1. Possess cognitive skills necessary to read and interpret a variety of instructions furnished in oral or written form. 

1. Must demonstrate tact patience and good communication skills. 

1. Must respect and maintain confidentiality at all times. 

1. Maintain professional appearance and demeanor at all times. 

The above referenced role and responsibilities are intended to describe the general content and requirements for the performance of this position.  It is not considered to be an exhaustive statement of duties, responsibilities, or requirements.