Ambulatory Coding and Documentation Specialist

Responsibilities:

• Review and interpret patient medical record documentation (progress notes, operative reports, discharge summaries, charge documents) to determine services provided and identify pertinent diagnoses and procedures.
• Assigns ICD-10-CM, ICD-10-CM and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for ambulatory clinic visit records
• Maintain current knowledge of coding guidelines, reimbursement reporting requirements; educate staff and physicians in accurate data collection to ensure efficient and timely claim submission.
• Review secured authorizations and pre-billed claims as needed to ensure they adequately reflect the procedures preformed
• In partnership with coding colleagues, educate provider community through independent audit analysis to ensure knowledge and understanding of correct coding and documentation policies and procedures
• Identify payor related issues and report to management team.
• Work in coordination with other members of the Physicians' Billing & Compliance Office as necessary
• Recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed
• Take ownership of special projects and follow through with detailed action plans
• Assure consistent quality and cost effectiveness of daily operations through coordination with physicians, patients, process assessment, and review of financial reports generated EPIC.

Credentials:

• CCS or Certified Procedural Coder - CPC (AAPC) - (Required)
• RHIA, RHIT (Preferred)
  

Education or Equivalent Experience:

• Bachelor's Degree (Required); preferably in HIM, healthcare, or related field (Required)
• 2+ years of relevant coding medical professional services experience including ambulatory outpatient and risk adjustment coding (Required)
• Additional experience could be considered in lieu of degree.

Skills & Abilities:

• Ability to effectively present information and respond to questions from others
• Ability to communicate effectively with all levels of staff
• Knowledge of medical terminology, human anatomy and physiology, and clinical disease processes
• Detail-oriented, organized and flexible with exceptional interpersonal and communication skills
• Demonstrates coding skills and critical thinking skills utilizing current policies and procedures
• Understanding of both clinical and revenue cycle operations
• Advanced knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines.
• Ability to work well independently and productively with minimal guidance and supervision