Coding Specialist III at University Health Partners of Hawaii

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Full Time

Start Date

Immediate

Expiry Date

21 May, 26

Salary

30.0

Posted On

20 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Coding, ICD-10, CPT, Medical Terminology, Interpersonal Skills, Communication, Analytical Skills, Proofreading, Customer Service, Medical Billing, ICD-9, CPT-4, E/M Coding, Modifier Rules, Documentation Review

Industry

Medical Practices

Description

POSITION SUMMARY The Coding Specialist III is responsible for coding inpatient and outpatient records for clinical departments with complex coding functions, such as procedure codes, E/M and complex modifier rules. Reviews the entire medical record and assigns the correct ICD and CPT codes to each data element. Reviews and evaluates coding denials for coding accuracy and assists with denial resolution. Contacts and works with physicians as needed for clarification. Participates in coding reviews. Develops and conducts clinical department or CBO coding training for faculty and staff, as appropriate to the location of their position. Assists the CBO managers with work flow and other responsibilities as assigned. ESSENTIAL JOB DUTIES AND FUNCTIONS * Assists and trains clinicians and staff with coding and medical billing issues. * Provides technical guidance to physicians and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, or codes that do not conform to approved coding principles/guidelines; educates and advises staff on proper code selection, documentation, procedures, and requirements. * Evaluates medical record documentation and provider coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect the outpatient visit, and to ensure that data comply with legal standards and guidelines; interprets medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct ICD and CPT codes. * Utilizes and applies AMA, Medicare, and specific payer guidelines in evaluating coding and medical records. When appropriate, uses specialty society recommendations in training physicians and other health care practitioners to improve accuracy of chart coding, proper code selection & required documentation. * Identifies performance issues and brings them to attention of the manager. * Works with internal staff to rationale for the purpose of obtaining all eligible reimbursements or to provide rationale based on coding principles to justify why service should not be appealed. * Demonstrates a thorough understanding of NCD, LCD, MUE & NCCI, and other Medicare/government regulations. * Stays abreast of current coding issues and changes; documents and communicates changes to department staff and provides training as required. * Reviews the complex (problematic coding that requires research and reference checking) medical records and accurately codes the primary/secondary diagnoses and procedures using ICD-9 CM, ICD-10, and/or CPT coding conventions. * Develops and presents training in coding for faculty members and staff. * Assist the Central Billing department by monitoring, following up, and reporting to providers on rejected/denied charges that they have had to resolve in task manager * Maintains strictest confidentiality, especially with regard to protected health information (PHI). * Complies with all legal requirements and company policies. * Performs all other duties as assigned. MINIMUM QUALIFICATION REQUIREMENTS Education/Training/Experience: * High school diploma or equivalent * Certified Professional Coder (CPC) or equivalent coding certification from an accredited body * Clerical experience in a clinical setting or medical office. * 4 years experience with a combination of coding and/or billing. * Medical records review experience. Skills Knowledge: * Excellent interpersonal skills.Knowledge of medical terminology. * Strong oral and written communication skills. * Proficient in using MS Word and Excel, with a working knowledge of databases and electronic communications. * Strong analytical skills. * Excellent English grammar and proofreading skills. * Excellent customer service skills. * Working knowledge of medical billing and collections. * Knowledge of ICD-9, ICD-10, and CPT-4, including both E/M and procedure coding. BENEFITS * Retirement plan with 3% dollar-for-dollar company matching contributions * Employee assistance program (EAP) * Pet insurance with competitive premium rate UHP is an EEO/AAP Employer.

Responsibilities

The Coding Specialist III is responsible for complex coding of inpatient and outpatient records, assigning correct ICD and CPT codes based on thorough medical record review and adherence to guidelines like NCD, LCD, MUE, and NCCI. This role also involves training faculty and staff on coding practices and assisting management with workflow responsibilities.