Pro Fee Coding Specialist

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

📋 Description

• Responsible for coding as assigned based on the review of medical record documentation.

• Utilizes knowledge of current coding and billing regulations to ensure accurate submission of claims.

• Monitors performance related to coding and billing, addressing denials that arise from coding mistakes.

• Conducts reviews for charge corrections and rebilling as necessary to resolve coding denials.

• Develops preventive strategies in response to trends identified through the analysis of claims denial data, and prepares regular reports for clinical staff that highlight corrective actions to tackle denial issues.

• Guides and instructs providers on documentation and billing policies, procedures, and regulations; engages with providers regarding any conflicting, ambiguous, or nonspecific documentation to obtain necessary clarifications.

• Trains providers and office staff on changes in documentation coding and billing regulations to ensure compliance with local, state, and national standards.

• Collaborates with providers, office staff, billing personnel, quality departments, compliance teams, and coding resources to guarantee accurate coding.

• Remains informed about coding guidelines, participates in seminars, and reviews coding-related publications.

⛳️ Requirements

• Minimum Education: GED or High School diploma required.

• Licensure, Registration, and/or Certification: (CCS) Certified Coding Specialist - American Health Information Management Association (AHIMA), (CPC) Certified Professional Coder - American Association of Professional Coders (AAPC), (BCHH-C) Board Certified Home Health Coding Credentialing – WellSky, (RHIA) Registered Health Information Administrator - American Health Information Management Association (AHIMA), (RHIT) Registered Health Information Technician - American Health Information Management Association (AHIMA), or Hierarchical Conditions Categories (HCCS) from The Compliance Certification Board (CCB).

• Candidates must obtain the required certification within one year of hire if they do not already possess it.

• Preferred experience and/or training in human anatomy, physiology, and disease processes to comprehend the etiology, pathology, symptoms, diagnostic studies, treatment methods, and prognosis of diseases and procedures to be coded.

• A minimum of 2 years of relevant experience is preferred.

• Strong knowledge and understanding of medical record content to locate information that supports or provides specificity for coding.

• Basic encoder skills are required.

• Familiarity with Microsoft 365 and other relevant software is necessary.

• Excellent communication skills, both written and verbal, to present information clearly and concisely.

• Effective interpersonal, organizational, and multitasking abilities.

• Capability to assess whether a record contains enough information to code or if it should be held for further documentation.

• Ability to be cooperative, dependable, and responsive to the dynamic nature of the coding workflow.

• Must be able to work independently and collaboratively in a fast-paced environment while managing multiple priorities with competing deadlines.

🏝️ Benefits

• None specified