Coding Specialist-Certified - Professional Coding

Under direction of the Manager – Professional Coding, the Coding Specialist-Certified is responsible for completing coding and charge entry functions for assigned St. Luke’s clinical departments or specialties in a timely manner, according to payer and regulatory rules. Responsible for reviewing electronic and written documentation to convert into diagnostic and / or procedure codes for routine and complex procedures. Responsible for working coding edits prior to claim submission and research of coding denials to maximize reimbursement for services rendered.

• MINIMUM QUALIFICATIONS

Education : High School diploma or equivalent, or post-secondary education.

• Experience : N / A
• Licensure / Certification / Registration : Approved coding certification from AHIMA or AAPC OR ten (10) years experience in billing, coding and / or denial management and RHIA or RHIT certification.
• PREFERRED QUALIFICATIONS

Education : N / A

• Experience : Six (6) months outpatient coding experience.
• Licensure / Certification / Registration : N / A
• KNOWLEDGE, SKILLS AND ABILITIES

Knowledge of physician office diagnosis and procedure coding (ICD-10, CPT, HCPCS). Knowledge of medical office billing procedures including Medicare compliance, insurance verification and private pay arrangements. Knowledge of anatomy and physiology and medical terminology. Knowledge of medical record documentation principles that support physician office visit coding. Knowledge of personal computing applications and skill in computer keyboarding. Knowledge of adult education principles. Numerical aptitude and ability to perform accurate, detailed work. Ability to effectively communicate with patients, physicians, client company representatives, attorneys, support staff, and administration. Ability to understand and follow complex oral and written instructions and explain complex medical terms and insurance requirements in easily understood terms. Ability to prioritize and complete tasks in an independent manner. Ability to demonstrate good judgment and accept personal responsibility. Ability to present a professional image. Ability to initiate appropriate action to resolve insurance claim rejections. Ability to maintain patient and client confidentiality. Ability to write legibly, see, hear, read, speak English.

• READING - Intermediate : Ability to read and interpret documents such as operating and maintenance instructions and procedure manuals.
• WRITING - Intermediate : Ability to write routine reports, correspondence, or procedures.
• SPEAKING - Intermediate : Ability to effectively present information in one-on-one, small group situations or before groups of customers, clients, and other employees of the organization.
• MATHEMATICAL SKILLS - Basic Skills : Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
• REASONING ABILITY - Intermediate Skills : Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
• PHYSICAL DEMANDS AND ENVIRONMENT

PHYSICAL DEMANDS

Prolonged, extensive, considerable sitting, walking and bending. Considerable reaching, stopping, kneeling and crouching and lifts objects up to twenty-five (25) pounds in weight.

• Stand - Occasionally Under 1 / 3 (1-2.5 hours)
• Walk - Occasionally Under 1 / 3 (1-2.5 hours)
• Sit - Continuously Over 2 / 3 (5.5 – 8 hours)
• Use hands to finger, handle, or feel - Continuously Over 2 / 3 (5.5 – 8 hours)
• Reach with hands and arms - Occasionally Under 1 / 3 (1-2.5 hours)
• Stoop, Squat, Kneel, or Crouch - Occasionally Under 1 / 3 (1-2.5 hours)
• Bending-repetitive forward - Occasionally Under 1 / 3 (1-2.5 hours)
• Talk or hear - Continuously Over 2 / 3 (5.5 – 8 hours)

LIFTING REQUIREMENTS

Up to 10 pounds - Frequently 1 / 3 to 2 / 3 (2.5 – 5.5 hours)

• Up to 25 pounds - Occasionally Under 1 / 3 (1-2.5 hours)

WORK ENVIRONMENT

Typical Noise Level - Moderate noise (examples : business office with computers and printers, light traffic)

• WORKING CONDITIONS

Works in a normal clinic business office environment.

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