Coding Reimbursement Specialist II

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct initial charge reviews to identify the correct ICD-10 and CPT codes for physician services billed to external payers.

• Analyze progress notes, operative reports, discharge summaries, and charge documents to accurately assign CPT and ICD-10 codes in accordance with AMA guidelines.

• Input the appropriate codes, diagnoses, and modifiers into the TMP billing system to finalize the charge process.

• Process charges following departmental timeliness standards.

• Collaborate with team members and practice management to ensure adherence to processing guidelines.

• Engage with physicians through query protocols concerning procedures and other billed services.

• Examine patient logs and clinical activity reports to guarantee that billing is recorded for all patients.

• Assess physician documentation for compliance with third-party and regulatory standards.

• Collaborate with Reimbursement staff to address coding and billing inquiries related to TMP physicians’ services.

• Carry out additional related tasks as required and assigned.

⛳️ Requirements

• A high school diploma or completion of a GED is mandatory.

• At least three (3) years of experience in CPT and ICD-10 coding for physician services is essential.

• Coding certification is required.

• CPC Certification is preferred.

• Must sustain active certification and fulfill required CEUs throughout employment.

• Advanced proficiency in medical terminology, anatomy, and physiology is required.

• Knowledge of and capability to apply payer-specific rules related to coding, bundling, and appropriate modifiers.

• Familiarity with and understanding of regulatory guidelines, including NCDs and LCDs.

• Experience in Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, and Dermatology is preferred.

• Awareness of current third-party billing and collection regulatory guidelines and requirements.

• Advanced understanding of the ICD-10 CM/PCS and CPT/HCPCS coding systems and conventions.

• In-depth knowledge of Official Coding Guidelines and methodologies.

• Strong interpersonal skills and a fundamental comprehension of team dynamics.

• Ability to collect and interpret clinical data effectively.

• Capability to work independently in a fast-paced environment.

• Must be able to lift and support a weight of 35 pounds.

• Attention to detail is essential.

• Proficiency in using a computer for extended periods.

🏝️ Benefits

• Competitive salary and compensation package.

• Comprehensive health, dental, and vision insurance.

• Retirement savings plans with employer matching.

• Opportunities for professional development and continued education.

• Flexible work schedule and remote work options.