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DEPARTMENT: 68221 – Business Office NCHHG
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LOCATION: 1100 Immokalee Road, Naples, FL, 34110
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WORK TYPE: Full Time
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WORK SCHEDULE: 8 Hour Day
ABOUT NCH
NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.
NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH – for you and every person we serve together. Visit nchjobs.org to learn more.
JOB SUMMARY
The Coding Specialist is responsible for all aspects of medical coding for physician services. This includes office, outpatient, hospital – both inpatient and outpatient, and ancillary services. The Coding Specialist will understand ICD-10, CPT and HCPCS coding; have the ability to interpret insurance guidelines relative to medical coding; understand abbreviations and medical terminology; have the ability to read a medical chart; and be able to understand the basic components of medical and ancillary procedures. This position will have responsibility for reviewing medical records for inpatient and outpatient visits and procedures and code them appropriately and accurately. This position will have responsibility for educating physicians and healthcare providers in correct coding in order to improve accuracy. Position will identify opportunities for improvement and bring issues to the attention of the Coding Lead. The position will include duties such as data entry, claims filing, review of remittance advices, patient account inquiries, and research on coding related denials.
ESSENTIAL DUTIES AND RESPONSIBILITIES
– Other duties may be assigned.
- Reviews medical records in order to code visits and procedures to highest specificity and accuracy according to NCH Physician Group’s policies.
- Performs review of recon reports in order to make necessary corrections and refile charges promptly and accurately.
- Provides education to Physicians and healthcare staff regarding correct coding rules and procedures, advising in proper code selection, required documentation, and other requirements. Ensures appropriate and efficient outpatient and inpatient professional coding.
- Reviews insurance Explanation of Benefits and all billing correspondence for denials, trends, and payment errors making necessary corrections to ensure payment.
- Responsible for coding Charge Review, Claim Edits, Payer Rejection and coding Follow Up work queues.
- Meet productivity goals for all coding work queues as assigned by Management.
- Meet coding accuracy goals as assigned by Management.
- Meets performance goals as defined by Senior Management (ex: Clean claim rate, days in A/R, and pre-A/R days, etc.)
- Assists with training of onboarding Coding Specialists.
- Assist RC Denial and Appeal Specialists with drafting and verbiage to use in appeals.
- Stays current on all CPT and ICD-10 changes and issues, and insurance/ contractual updates that affect reimbursement.
- Associate may review patient accounts as requested by customer service department to research billing/coding issues.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
- Minimum of High School or GED required
- Associate Degree preferred
- 1-year Professional Coding required.
- 2-years Medical Billing experience preferred.
- MUST be a Certified Professional Coder (CPC), through the American Academy of Professional Coders (AAPC).
- EPIC software experience preferred.
- Must have basic accounting knowledge and skills.
- Must have excellent communication skills- both verbal and written.
- Computer experience with PC required.
- Knowledge of CPT and ICD-10 codes.
- Knowledge of medical terminology.
- Proven self-starter with ability to motivate personnel.
- Intermediate computer knowledge: Uses Microsoft Word, Excel, Outlook, and Windows.
- Reliable high speed internet connection required.
- Reliable phone access required
- Ability to work independently, effective time management, and proficiency in remote environment.
- Knowledge of virtual meeting applications (WebEx, Microsoft Teams, etc..) is a must.
