Outpatient Medical Coding Specialist
Thank you for considering ProBill as a potential employer.
ProBill HR Department
Phone: 800-377-8721 ext.295
Understand clinical content of a health record and assign appropriate ICD-9, ICD-10, HCPCS, and CPT codes in accordance with offical guidelines and Bettinger/Stimler methodologies.
1. AHIMA and/or AAPC certification required.
2. Certified CPC and/or ED Coding and ICD-10 Certification.
3. Two years’ experience with outpatient coding and denials management.
4. One year experience in another aspect of medical billing.
5. Maintain required CEU hours.
6. Comprehensive knowledge of medical terminology, anatomy, and physiology, and diagnostic and procedural coding (CPT, ICD-9, ICD-10, and HCPCS).
7. Computer experience utilizing various systems, applications, and websites, i.e. GE, Centricity, Microsoft Work, Excel, Adobe, super coder, etc.
8. Ability to access and recognize appropriate electronic documents and medical record contents necessary for coding.
9. Analyze and resolve claim edits, denials, and assist with appeals process.
10. Knowledge of PQRS quality reporting.
11. Effectively communicate coding methodologies and documentations best practices with coworkers, clients, patients and insurance carriers.
12. Knowledge of Medicare, Medicaid and State regulations.
13. Some travel may be required.
1. Translate physician services into the appropriate CPT, ICD-9, and ICD-10 codes.
2. Enter codes into the billing system for claim and statement distribution.
3. Identify and flag chart deficiencies within the billing system.
4. Process and follow up on coding denials and update incorrect claims.
5. Perform chart reviews and audits for new business development.
6. Educate providers on documentation according to CMS 1995/1997 guidelines.
7. Maintain quality and production standards as set forth by company guidelines.
8. Maintain records of daily production.
9. Maintain confidentiality and adhere to HIPAA regulations.
10. Perform daily tasks with frequent interruptions and change in work priorities, as necessary.
11. Must be able to function in an independent, collaborative, and shared leadership environment.
12. Required to learn other job functions to assist other departments with their goals.
1. Ability to analyze and interpret data with minimal supervision.
2. Ability to work independently and prioritize work load with little or no supervision in a fast paced environment.
3. Ability to collaborate and interact with various departments.
4. Ability to articulate and educate physicians on best documentation practices.
5. Ability to sit for prolonged periods of time to perform repetitious tasks.