Medical Coding Specialist

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

📋 Description

• Evaluates medical record documentation and accurately assigns the relevant ICD-9-CM, ICD-10, CPT IV, and HCPCS codes using 3M software tools for all outpatient work types.

• The codes assigned must substantiate the reason for the visit and the medical necessity documented by the provider to justify the care rendered.

• When applicable, apply the necessary charges such as Evaluation & Management (E&M) levels, injections, infusions, and other requirements for observation cases, utilizing third-party software systems like LYNX.

• Accurately abstract required data following facility specifications.

• Conduct "medical necessity checks" for Medicare and other payers as mandated by payment guidelines.

• Responsible for monitoring and managing accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis as a team, ensuring prompt and compliant processing of outpatient claims in the billing system.

• Tasked with maintaining established productivity standards and key performance indicators for 3M 360 CAC for CRS & Direct Code, while also ensuring accuracy to uphold established quality benchmarks.

• Stay informed of the latest requirements from the Centers for Medicare & Medicaid Services (CMS), including National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) guidelines related to modifier assignment, to guarantee the submission of a clean claim on the first attempt.

• Maintain proficiency and accuracy while utilizing essential tools such as the 3M encoder, Computerized Assisted Coding (CAC), Medical Necessity software, abstracting systems, code books, and other reference materials.

• Report any inaccuracies encountered in coding software to HIM Management/Supervisor and disclose any potential unethical or fraudulent activities as per compliance policies.

• Participate in mandatory system, hospital, and departmental meetings and educational sessions as required by leadership, as well as complete necessary annual learning programs to ensure ongoing education and development.

⛳️ Requirements

• Minimum of 1 year of previous coding experience.

• Proficient in PC and computer applications.

• Navigational and basic functional proficiency in Microsoft business software (Excel, Word, PowerPoint).

• Excellent organizational skills, along with effective communication, time management, troubleshooting, and problem-solving abilities.

• Capability to multi-task and prioritize tasks to meet both short- and long-term deadlines.

• Familiarity with EPIC and prior experience using coding software tools.

• AAPC or AHIMA Coding Certification: CPC-A, CPC, CCA, or CCS.

🏝️ Benefits

• Bonus Incentives.

• Paid Certifications.

• Tuition Reimbursement.

• Comprehensive Benefits.

• Career Advancement.