Job Summary
The Coding Coordinator is responsible for coordinating resolution of assigned complex coding denials, and questions related to claims coding for HPI clients. The Coordinator will perform auditing of offshore coding for quality assurance and education, collaborating with assigned client/RCM teams providing education on coding denial trends and or opportunities for coding improvement and documentation requirements. The Coordinator may also perform production coding for ICD-10 and CPT coding as required by clients.
The Coding Coordinator will also perform provider audits, document findings and share outcome results and recommendations to the client and provider in conjunction with the Director of Coding Services.
The Coding Coordinator will also create presentations, develop learning material, and provide feedback to internal and external customers on denials and coding improvements in conjunction with the Director of Coding Services.
Duties/Responsibilities
- Adheres to HPI’s Coding Code of Conduct Policy.
- Maintains knowledge of ICD10 and CPT classifications and coding of diagnoses and procedures.
- Able to perform production coding as required for assignment of diagnosis and procedure codes and applicable modifiers.
- Demonstrate extensive knowledge of clinical documentation to help ensure the use of proper diagnostic and procedure code assignments.
- Monitors coding work and trends, providing education where opportunities are identified. Able to apply policies and procedures on documentation and coding consistent with state and federal regulations.
- Monitors payer policies based upon client’s region. Applies specific payer policies and procedures with documentation and coding as required.
- Ability to work independently making appropriate clinical decisions for assigned client coding denial work queues, understand the impact to the provider and client while maintaining compliance.
- Responsible for quality monitoring audits for offshore coding for assigned clients and education.
- Coordinates coding guidance to billing team, offshore and clients working closely with the Director of Coding Services.
- Performs and prepares audit results and special projects as assigned.
- Other duties as assigned.
Education and Experience:
- Demonstrated proficiency in multiple physician specialty coding as normally obtained through 3-5 years of current and progressive coding experience
- Coding Certification: Certified Coding Specialist (CCS), Certified Professional Coder (CPC)
- Moderate to advanced knowledge of CCI edits, NCDs/LCDs and be able to accurately apply knowledge to coding
- Excellent time management and attention to detail are critical
- Ability to research answers that are not readily available
- Ability to work independently and collaborate in team environments
- Ability to articulate communicate and coordinate education to achieve highest results
- Computer savvy with Microsoft Suite Excel, Word, PowerPoint, Outlook and Teams; uses for day-to-day work production
- Experience with Athena Centricity Practice Management and or NextGen is a plus, as well as other physician-based PM systems
- Thrives in a deadline-driven, fast paced environment
- Actively supports change
- Inspires respect and trust
Physical Requirements:
- Work is performed remotely, in a home office setting
- The noise level in the remote work environment should be quiet and conducive to a work setting
- Prolonged periods sitting at a desk and working on a computer.
- Must be able to lift up to 15 pounds.
Health Prime is an Equal Opportunity Employer