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Coding & Auditing Specialist Job in Norfolk, Virginia

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Job Title: Coding & Auditing Specialist

Skills:Conduct provider audits and provide ongoing education to physicians to maximize compliance and reimbursement.
Specialties:Surgical Coding experience is highly desirable
Required Certifications:Certified Professional Coder certification (CCS-P/CPC)
Required Experience:3 to 4 years
Location:601 Children's Lane Norfolk 23507, VA, US
Date Posted:9/26/2018

Analyze and interpret medical information in the medical record and assign/sequence the correct ICD-10-CM, CPT, and/or HCPCS code to the diagnoses/procedures of office, inpatient and/or outpatient medical records, including operative reports, according to established coding guidelines.   Knowledge of surgical coding and the ability to review and natively code complex operative procedure reports.  In accordance with Coding Compliance team guidelines, conduct provider audits and provide ongoing education to physicians to maximize compliance and reimbursement.   Responsible for the collection of relevant, pertinent, accurate and timely diagnosis and/or procedural codes abstracted from all office and hospital case types including complex medical/surgical inpatient cases (such as neonates, pediatric cardiothoracic surgery, pediatric neurosurgery, pediatric orthopedics, pediatric plastic surgery, pediatric urology, general pediatric surgery and pediatric trauma services.) or other advanced types of services including surgical, observation, outpatient, and specialty procedures. This includes effective use of encoding and edits systems and resources as well as recognizing what data can be abstracted, presented and interpreted for coding and billing..     Interact with and provide support to Billing office and facility staff to answer questions and resolve rejected fee tickets and claims.


Employ strong understanding of the encounter/billing process, and working knowledge of payers, as well as, their impact on reimbursement. Utilize medical reference resources and contacts to thoroughly research coding issues and to maintain working knowledge of payment/reimbursement systems to ensure maximum reimbursement and coding compliance.  Identify opportunities for billing/coding improvements. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, criteria for benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs.  Meet or exceed productivity and quality standards as assigned by management.

Take responsibility for various projects as assigned by management and perform any additional/miscellaneous duties (not inclusive of job description) as requested by the management team within the scope of knowledge/ability.

Work as a team player and communicate in a positive manner with co-workers, managers, providers, and other contacts.   Maintain patient confidentiality at all times.


Surgical Coding experience is highly desirable.  Onsite position. 


Coding certification from AAPC required



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