JOB DESCRIPTION (JD)

Role- Certified Coding Specialist- Physician

Specialty- Evaluation & Management (E&M)

Education & Certification:

• Graduation in any Life sciences- Physiotherapy, Pharmacy, Nursing, Biosciences with Anatomy/physiology as a subject.
• Certified Professional Coder (CPC) credentialed from the American Academy of Professional Coders (AAPC) obtained before hire or job transfer. All specialties accepted.
• Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) obtained before hire or job transfer. 

Requirements:

• Experience in E&M Specialty Coding- Outpatient, Inpatient, observation, Critical care facilities using ICD, Modifiers, CPT, HCPCS codes.
• Must have a minimum 3+ years of experience in E&M inpatient and/or outpatient medical record review, coding and reimbursement. Coding audit experience preferred.
• Must have strong knowledge of ICD-10 CM/PCS and CPT coding and prospective payment systems and proficiency with Microsoft Windows operating systems and Office applications, such as Word, Excel, PowerPoint
• Able to work well with minimal supervision.
• Able to communicate clearly both written and verbally.
• Able to generate reports for management review that present audit results in a clear manner.
• Able to meet deadlines and respond well to frequent changes in regulation.
• Able to maintain positive and productive relationships with internal and external teams and customers.
• Able to work independently and be a self-starter.

Roles & Responsibilities:

• In conjunction with the Coding Supervisors and Coding Manager, contributes to the development of educational and training opportunities for staff.
• Creates update tracker and responsible for updating the team on trends and changes.
• Provides feedback & coaching on common error scenarios
• Performs review of claims denied/rejected for coding, documentation and clinical validation.
• Prepares reports for management review and identifies trends.
• Conducts focused retrospective audits and regular scheduled audits of individual coders.
• Creates update tracker and responsible for updating the team on trends and changes.
• In conjunction with the Coding Supervisors and Coding Manager, contributes to the development of educational and training opportunities for staff.