Pro Fee Coding Specialist
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Job Description
Part-time Pro Fee Coding Specialist reviewing medical records and correcting diagnosis and procedure codes. Supporting accurate billing, denial resolution, and provider compliance for Saint Francis healthcare services.
Responsibilities:
- Review medical record documentation and code assigned diagnoses and procedures
- Add or correct diagnosis and procedure codes submitted by providers
- Apply current coding and billing requirements to ensure accurate claims submission
- Monitor coding and billing performance and resolve denials related to coding errors
- Review charge corrections and rebilling requests for coding-denial resolution
- Analyze claims-denial patterns and develop preventative measures
- Prepare periodic reports for clinical staff identifying corrective measures
- Advise and instruct providers on documentation and billing policies, procedures, and regulations
- Obtain clarification from providers regarding conflicting, ambiguous, or nonspecific documentation
- Educate providers and office staff on coding, billing, documentation, and regulatory changes
- Collaborate with providers, office staff, billing personnel, quality, compliance, and coding resources
- Stay current on coding rules through seminars, reviews, and coding periodicals
Requirements:
- GED or High School diploma
- One of the following certifications: CCS, CPC, BCHH-C, RHIA, RHIT, or HCCS; applicants without a required certification must obtain one within one year of hire
- Sound knowledge and understanding of medical records and coding documentation
- Basic encoder skills
- Knowledge of Microsoft 365 and other applicable software
- Ability to determine whether records are complete enough to code
- Ability to work independently and collaboratively in a fast-paced environment while managing multiple priorities and deadlines
- Experience and/or training in human anatomy, physiology, disease processes, and coding-related clinical concepts preferred
- 2 years of related experience preferred
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