Certified Medical Coding Specialist Job in Baltimore, Maryland

JOB SUMMARY:

Certified Medical Coding Specialist will be required to utilize CPT, ICD-10, HCPCs and EMR to categorize patient’s Billing Summary for the purpose of coding, billing, record keeping, archiving and cataloging for Chase Brexton Health Care as Federally Qualified Health Center (FQHC). The position requires that the Specialist learn and understand Federally Qualified Health Centers and the Medicare and Medicaid guidelines.

Medical Coding Specialist is responsible addressing rejected and denied claims, acting as a communication link between billing office and clinical staff, providing ongoing education regarding coding guidelines and changes. The Medical Coding Specialist must be skilled in understanding medical terminology, Evaluation and Management ’97 Guidelines, identifying diagnoses, conditions, services and procedures documented in provider’s medical record.

Will be required to review medical records, patient information and health insurance to ensure accurate coding for procedures and diagnosis’ for FQHC billing purposes. Run weekly reports on aged patient accounts and address with appropriate staff for resolution and closure of open accounts for revenue cycle purposes.

Presentation and educational skills a must. The Specialist will be required to create, educate and present to providers in meetings on organizational updates/changes and be comfortable with presentations to leadership/clinical staff to ensure standardization through the organization.

MAJOR DUTIES AND RESPONSIBILITIES:

·         Learn and understand Federally Qualified Health Centers and the Medicare and Medicaid guidelines

• Responsible for maintaining coding compliance for Federally Qualified Health Center and multi-specialty clinic

·         Identify areas of coding weakness and develop educational training plans to address

·         Review/Audits patient disputes surrounding inappropriate coding in a timely manner

·         Review/Audits insurance denials related to coding questions in a timely manner, providing remedy as needed

·         Coordinate Education notices to Providers on quarterly audits from vendor

·         Review Audits with new providers on vendor’s findings and summaries

·         Assist the billing/collection specialists in verifying and correction coding issues per the insurance request or claim denials

·         Keep updated list of/training around carrier coding requirements

·         Monthly Coding Updates to Staff based on industry requirements

·         Perform internal quality assurance - summarize findings and report these to the Manager

·         Other Billing work as assigned