About Wilmington Health

Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence- based medicine in providing the highest quality of care to the patients we serve.

Essential Duties/Responsibilities:

• Review medical record documentation and ensure accurate diagnosis and procedure code assignment to patient records for data retrieval, analysis, and claim processing.
• Works with physicians, non-physician practitioners, and other health care professionals to obtain any necessary clarification for accurate diagnosis and procedural coding.
• Expertise in assigning accurate CPT®, HCPCS Level II, and ICD-10-CM medical codes and modifiers based on coding and payer guidelines.

• Able to work with little supervision and perform all work independently, with high autonomy.
• Consistently meets 100% productivity measures and quality requirements.
• Maintains coding certification by completing continuing education requirements.
• Maintains a solid understanding of anatomy, physiology, and medical terminology as required to accurately code provider services and diagnoses.

• Abide by HIPAA regulations, maintaining confidentiality in all areas to protect sensitive health information.
• Post patient & insurance payments & refunds
• Follow-up with payers regarding outstanding claims
• File claims that require additional documentation
• Insurance Denials/Appeals
• Communicate all insurance regulation changes to supervisor.
• Contact patient and or carrier to follow-up on denials and termination of coverage

• Respond to telephone calls; review and respond to correspondence
• Reconcile bank statements
• Prepare bank deposits
• Patient collections

Other Duties:

As assigned by manager

General:

• Customer Service
• Professionalism/Integrity/Responsibility
• Teamwork/Process Focus
• Dependability/Punctuality
• Interpersonal Relationships/Communication
• Judgment/Decision Making/Problem Solving
• Quality/Quantity
• Initiative
• Safety/Housekeeping
• Organizational Skills/Time Management

Required Qualifications:

• High school diploma or equivalency
• 2 years of coding for physician/facility/anesthesia services

License/certification Requirements:

• CPC, CCS-P, CCS or CCA. Any AHIMA or AAPC certification.

ADA Physical Demands:

Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)